Am. Klein et Tc. Banever, Enterocutaneous fistula as a postoperative complication of laparoscopic inguinal hernia repair, SURG LAP EN, 9(1), 1999, pp. 60-62
Trocar injuries to the small bowel during laparoscopic hernia repair are a
rare complication, the most common complications being postoperative neural
gias, scrotal swelling, scrotal ecchymosis, and hematoma. A 15-year-old boy
was admitted 5 days status-post transabdominal laparoscopic inguinal herni
a repair of a symptomatic right pantaloon hernia, with signs and symptoms o
f a retrocecal abscess. Despite laparotic intervention and appendectomy, th
e next 2 years passed with almost daily, purulent, right lower quadrant wou
nd drainage, in an otherwise asymptomatic patient. Superficial wound explor
ation and sinogram in 1996 revealed a sinus tract in direct communication w
ith the small bowel. Elective laparotomy in December 1997 involved a succes
sful resection of a 2.5-cm fistula with involved mesh, and the communicatin
g small bowel through a midline incision, followed by a primary closure of
the small-bowel opening. The patient has recovered without complications.