Laparoscopic Management of Early Post operative Small Bowel Adhesive Obstruction following Hysterectomy: a Series of 2 Cases

Volume 1 - Issue 2

Kavitha Yogini Duraisamy*, Devi Balasubramaniam, Amrutha Kakollu and Palanivelu Chinnusamy

Received: December 21, 2017;   Published: January 18, 2018

DOI: 10.32474/IGWHC.2018.01.000106

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Abstract

Objective: To describe laparoscopic management of two cases of early post operative small bowel obstruction. One case that occurred after a total laparoscopic hysterectomy with uterosacral colpopexy and the second case following vaginal hysterectomy.

Design: Case series

Setting: Academic Medical and Research Centre.

Patient: We report a 50 year old woman who developed small bowel obstruction five days after total laparoscopic hysterectomy with bilateral salpingo oophorectomy and uterosacral colpopexy due to adhesion of an ileal loop to the vaginal vault. The second patient presented ten days after vaginal hysterectomy with symptoms of bowel obstruction

Intervention: Both patients were managed conservatively for 48 hours with bowel rest and intravenous hydration. Due to unsatisfactory recovery of clinical symptoms and supportive radiologic findings, diagnostic laparoscopy was performed. The adherent ileal loop was released by blunt dissection in both the cases. Immediate clinical improvement was seen during post operative period.

Main Outcome Measure: Clinical resolution of small bowel obstruction symptoms

Result: No bowel resection was needed.

Conclusion: Adhesive small bowel obstruction can occur in the immediate post operative period and can be managed laparoscopic ally. It can occur following laparoscopic and vaginal hysterectomy in low risk patients and should be borne in mind when evaluating symptoms of small bowel obstruction in these patients.

Keywords: Laparoscopy; Hysterectomy; Post Operative Adhesions; Small Bowel Obstruction

Abstract| Introduction| Case Report| Discussion| Conclusion| Acknowledgement| References|