부산대학교 도서관

An 82-year-old man underwent laparoscopic hernia repair of bilateral direct inguinal hernias. He was discharged on the day after surgery, but on postoperative Day 6, he presented to our outpatient clinic complaining of epigastric pain. Small bowel obstruction was diagnosed by diagnostic imaging, and he was readmitted. It was considered that the small bowel obstruction was due to dehiscence at the peritoneal suture site, and he was started on conservative therapy with the placement of a long intestinal tube. The symptoms of small bowel obstruction improved immediately, enabling the removal of the tube and the start of oral food intake. Although there has been no subsequent recurrence of small bowel obstruction, elective diagnostic laparoscopy was performed. Dehiscence of the peritoneal suture site was confirmed, and this was closed laparoscopically by simple suturing. The patient started food intake again on the day after the revision surgery, and since no subsequent major complications occurred, he was discharged home on Day 6 after the operation. The possibility of peritoneal suture dehiscence must be borne in mind when treating small bowel obstruction that occurs after laparoscopic hernia repair. This case suggests that conservative therapy should be started first, and that surgery should be considered at the earliest opportunity.