Ileal perforation due to a Richter hernia at the drain insertion site following an operation for idiopathic rectal perforation: report of a case

Surg Today. 2000;30(1):66-8. doi: 10.1007/PL00010050.

Abstract

A case of a Richter hernia at the insertion site of the drainage tube following open abdominal surgery is reported. A 54-year-old man underwent an emergency operation for an idiopathic rectal perforation. A partial resection of the rectum and drainage using four 10-mm (outer diameter) drainage tubes with round cross sections was performed. Despite an uneventful early postoperative course, an emergency reoperation was required for peritonitis due to a bowel perforation 14 days after removing the drain inserted into the rectosacral space. A laparotomy revealed an incarcerated Richter hernia with ileal perforation through the 10-mm drainage site. The postoperative course after a partial resection of the ileum and drainage with Penrose drains was uneventful. This is the first report of a Richter hernia through the insertion site of a drainage tube in abdominal surgery. The possible occurrence of a Richter hernia in cases with postoperative drainage using large-size round drainage tubes should thus be considered in such patients.

Publication types

  • Case Reports

MeSH terms

  • Drainage
  • Hernia, Ventral / complications*
  • Hernia, Ventral / etiology
  • Humans
  • Ileal Diseases / etiology*
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / surgery
  • Intubation / adverse effects*
  • Intubation / instrumentation
  • Male
  • Middle Aged
  • Rectal Diseases / surgery*