Abstract
Laparoscopic management of acute adhesive small bowel obstruction has been shown to be feasible and advantageous. However, widespread acceptance and application is still not observed. We describe the case report of a 58-year-old male who presented with signs and symptoms of small bowel obstruction status twenty years after two consecutive open surgeries for complicated acute appendicitis. The patient underwent successfully a laparoscopic band lysis after failure of conservative management. This is the first report of laparoscopic management of adhesive small bowel obstruction in Cameroon. Laparoscopic adhesiolysis of acute adhesive small bowel obstruction is feasible and safe by skilled surgeons in selected patients even in developing countries.
Highlights
Small bowel obstruction (SBO) is a common cause of surgical admissions from a surgical emergency department, adhesions being the commonest etiology and are related to prior laparotomy [1]
We report a case of a 58-year-old male who presented with signs and symptoms of postoperative SBO managed successfully by laparoscopic lysis
The standard surgical approach to acute SBO has been laparotomy, even in developing countries; of 9,619 SBO operated in USA from 2005 to 2010 only 14,9% adhesiolysis were performed laparoscopically [5]
Summary
Small bowel obstruction (SBO) is a common cause of surgical admissions from a surgical emergency department, adhesions being the commonest etiology and are related to prior laparotomy [1]. We report a case of a 58-year-old male who presented with signs and symptoms of postoperative SBO managed successfully by laparoscopic lysis. The patient's past medical history was significant for two open laparotomies twenty years before when he presented with an acute appendicitis. He was managed firstly by a Mc Burney appendicectomy complicated five days later by an enterocutaneous fistula which required a midline open laparotomy. The patient was admitted to the visceral and laparoscopic surgery unit and observed overnight with a nasogastric tube, IV fluid hydratation and serial examination. At the subsequent outpatient follow-up visit, the patient was tolerating regular diet without difficulty
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