Jejunal torsion around the right ureter presenting as postoperative bowel obstruction: a case report

Abstract

IntroductionSince abdominal radical hysterectomy was first described by Clark and Reis in 1895, it has been commonly used in the primary surgical treatment of carcinoma of the cervix. We report the case of a 45-year-old woman who was diagnosed with a small bowel obstruction due to jejunal torsion to her right ureter mimicking postoperative adhesion ileus.Case presentationA 45-year-old Turkish woman was admitted to our emergency department with complaints of abdominal pain, constipation, nausea and vomiting. She had undergone an abdominal radical hysterectomy for cervical carcinoma three years earlier. Computed tomography scans revealed intestinal dilatation, a large amount of free fluid in the abdominal cavity and an area suspicious for jejunal perforation. Because of these radiological findings suggestive of obstruction and bowel ischemia, our patient underwent emergency surgery. Operative findings that showed a jejunal segment was turned around her right ureter so that it was mimicking a fibrous band.ConclusionsIn this current case, we present the first determined complication of radical hysterectomy. According to our case report, surgical oncologists should be aware of this complication and review the surgical technique. It is considered that readaptation of the dorsolateral peritoneal layer after extended pelvic lymph node dissection resulted in fewer complications.

Small bowel obstruction due to internal hernia caused by the ureter after laparoscopic radical cystectomy and ileal conduit: A case report

“…This is the first reported case of small bowel obstruction due to internal hernia caused by the ureter after laparoscopic radical cystectomy and ileal conduit. Similar cases can also occur after gynecologic surgeries such as radical hysterectomy , but only six such cases have been reported.…”

Retro-ureteral Small Bowel Herniation After Radical Cystectomy

“…Only six previous cases of retro-ureteral internal herniation have been documented. 1 , 2 , 3 , 4 , 5 Of the six previous cases, only one case occurred after primary urological surgery (ureteric reimplantation for vesicoureteric reflux) while all other documented cases occurred after gynaecological procedures. 1 , 2 , 3 , 4 There are no published cases of SBO caused by an internal herniation of the small bowel under a ureter following cystectomy and ileal conduit formation.…”