Strangulated intestinal hernia through a drain site

Falidas, Evangelos; Mathioulakis, Stavros; Vlachos, Konstantinos; Pavlakis, Emmanouil; Villias, Constantinos

doi:10.1016/j.ijscr.2011.06.002

Cited by 9 publications

(18 citation statements)

References 8 publications

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“…Because of the narrow neck this type of hernia tends to complicate with strangulation of its contents more than the other incisional hernia, inguinal hernia or paraumbilical hernia. Such case of DSH with strangulation of a loop of small bowel was reported by Evangelos Falidas et al [7]. Therefore the knowledge of occurrence of DSH is important for early identification and treatment to prevent such serious complications.…”

Section: Contents Of Dshmentioning

confidence: 80%

“…This shows the rarity of this condition and the incidence of DSH is reported to be ranged from 0.14%-3.4% [6]. It is said that DSH occurs 3 -8 hours after removal of the drain and Evangelos Falidas et al described a case of DSH occurred 15 hours after a laparotomy [7]. However according to the Preetha Rani drain-site hernia commonly occur several months to several years following a laparotomy and are mostly associated with incisional hernias of the main laparotomy scar [5].…”

Section: Drain Site Hernia (Dsh)mentioning

confidence: 99%

“…Those contents reported in the literature include small intestine, appendix, colon, omentum, gallbladder, ovary, and fallopian tube [3] [9] [10] [11]. Out of these structures the most commonly herniated abdominal viscera through a drain site were small bowel loops and appendix that may lead to obstruction or strangulation subsequently [5] [7]. Omentum is a common structure that is found in inguinal, incisional and paraumbilical hernia.…”

Section: Contents Of Dshmentioning

confidence: 99%

“…The factors that delay wound healing such as poor nutritional status, wound infection, certain drugs like steroid and chemotherapeutic agents, some comorbidities like diabetes mellitus, prolong surgery, obesity and injury to motor nerve are also known to cause DSH [3] [5] [7] [9] [12]. Direct stab on the peritoneum rather than allowing peritoneum to stretch and cut during insertion of the drain also predispose to hernia as the drain site wound directly continue with the external skin defect for the drain [3].…”

Section: Other Complications Of Drainsmentioning

confidence: 99%

“…However if it is unavoidable in any specific reasons, apply a purstring suture when ever drain is taken through 10 mm port site [5] [17]. Some authors recommend in applying a pustring suture for the closure of the site after drain removal to prevent occurrence of DSH [7].…”

Section: Prevention Of Complicationsmentioning

confidence: 99%

See 4 more Smart Citations

Drain Site Abdominal Hernia: Known but Rare Complication of Abdominal Drains, a Case Report and a Review of Drain Site Complications

Samarawickrama¹,

Senavirathna²,

Hapuarachchi³

2017

IOSRPHR

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Abstract:-Drains are being used in abdominal surgery since Hippocrates time therapeutically and prohpylactically aiming to reduce morbidity and early recovery of patients. But these drains are not without complications. The complications range from simple drain site infection to drain site hernia of bowel leading to strangulation and necrosis. We report a case of drain site hernia (DSH) in a 47 year-old women who presented with obstructed large incisional hernia through a previous laparotomy scar. During surgery for the incisional hernia an incarcerated DSH was identified at her right iliac fossa region. Both herniae were repaired successfully and patient's recovery was uneventful. We reviewed the literature regarding the drain site hernia and other complications of abdominal drains. The article describes types of drains, their complications and predisposing factors for those complications and the steps to be taken for the prevention.

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Section: Contents Of Dshmentioning

confidence: 80%

Section: Drain Site Hernia (Dsh)mentioning

confidence: 99%

Section: Contents Of Dshmentioning

confidence: 99%

Section: Other Complications Of Drainsmentioning

confidence: 99%

Section: Prevention Of Complicationsmentioning

confidence: 99%

See 3 more Smart Citations

Drain Site Abdominal Hernia: Known but Rare Complication of Abdominal Drains, a Case Report and a Review of Drain Site Complications

Samarawickrama¹,

Senavirathna²,

Hapuarachchi³

2017

IOSRPHR

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Omission of intraoperative drain placement during robotic partial nephrectomy and robotic radical prostatectomy is safe: an analysis of 18,000 patients

Pfail,

Drobner,

Kaldany

et al. 2024

World J Urol

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Purpose Placement of a drain during robotic assisted partial nephrectomy (RAPN) and robotic assisted radical prostatectomy (RARP) is standard practice for many urologists and can aid in assessment and management of complications such as urine leak, lymphocele, or bleeding. However, drain placement can cause discomfort and delay patient discharge, with questionable benefit. We aim to assess the correlation between drain placement with post operative complications. Methods The NSQIP targeted database was queried for patients who underwent RAPN or RARP from 2019 to 2021. Our primary outcomes included 30-day complication rates stratified by intraoperative drain placement. Secondary outcomes included procedure-specific complications, length of stay (LOS), and readmissions. Multivariable regression analyses, with Bonferroni correction, were performed for each post-operative complication. Results We identified 4738 and 13,948 patients who underwent RAPN and RARP, respectively. Drains were not placed in 2258 (47.7%) and 6700 (48%) patients, respectively. On adjusted multivariable analysis in the RAPN cohort, omission of drain placement was associated with decreased LOS (β -0.45; 99.58% CI [-0.59, -0.32]) but no difference in overall complication rates. After adjusted analysis in the RARP cohort, omission of drain placement was associated with decreased risk of any complication (OR 0.73 [0.62–0.87]), infectious complication (OR 0.66 [0.49–0.89]), and LOS (β -0.30 [-0.37, -0.24]). Conclusions Using a large contemporary database, this study demonstrates that omission of drains during RAPN and RARP was safe without increased risk of postoperative complications. Despite inherent selection bias in this cohort, our data suggests that routine drain placement is not necessary for these procedures.

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Drain-site hernia after laparoscopic rectal resection: A case report and review of literature

Jin¹,

Cheng²,

Yin³

2022

WJCC

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BACKGROUND Drain-site hernia (DSH) has an extremely low morbidity and has rarely been reported. Small bowel obstruction is a frequent concurrent condition in most cases of DSH, which commonly occurs at the ≥ 10 mm drain-site. Here we report a rare case of DSH at the lateral 5 mm port site one month postoperatively without visceral incarceration. Simultaneously, a brief review of the literature was conducted focusing on the risk factors, diagnosis, and prevention strategies for DSH. CASE SUMMARY A 76-year-old male patient was admitted to our institution with intermittent abdominal pain and a local abdominal mass which occurred one month after laparoscopic radical resection of rectal cancer one year ago. A computed tomography scan showed an abdominal wall hernia at the 5 mm former drain-site in the left lower quadrant, and that the content consisted of the large omentum. An elective herniorrhaphy was performed by closing the fascial defect and reinforcing the abdominal wall with a synthetic mesh simultaneously. The postoperative period was uneventful. The patient was discharged seven days after the operation without surgery-related complications at the 1-mo follow-up visit. CONCLUSION Emphasis should be placed on DSH despite the decreased use of intra-abdominal drainage. It is recommended that placement of a surgical drainage tube at the ≥ 10 mm trocar site should be avoided. Moreover, it is advisable to have a comprehensive understanding of the risk factors for DSH and complete closure of the fascial defect at the drainage site for high-risk patients.

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Strangulated intestinal hernia through a drain site

Abstract: Drains must be used with caution and only if indicated. Careful insertion, regular post-operative or post-removal inspection is strongly recommended.

Cited by 9 publications

References 8 publications

Drain Site Abdominal Hernia: Known but Rare Complication of Abdominal Drains, a Case Report and a Review of Drain Site Complications

Drain Site Abdominal Hernia: Known but Rare Complication of Abdominal Drains, a Case Report and a Review of Drain Site Complications

Omission of intraoperative drain placement during robotic partial nephrectomy and robotic radical prostatectomy is safe: an analysis of 18,000 patients

Drain-site hernia after laparoscopic rectal resection: A case report and review of literature

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