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Case Reports
. 2016 Jun 4:8:9-11.
doi: 10.1016/j.eucr.2016.05.003. eCollection 2016 Sep.

Internal Hernia Underneath an Elongated External Iliac Artery: A Complication After Extended Pelvic Lymphadenectomy and Robotic-assisted Laparoscopic Prostatectomy

Pascal Viktorin-Baier  1 , Marco Randazzo  1 , Cristoforo Medugno  2 , Hubert John  1
Affiliations
Case Reports

Internal Hernia Underneath an Elongated External Iliac Artery: A Complication After Extended Pelvic Lymphadenectomy and Robotic-assisted Laparoscopic Prostatectomy

Pascal Viktorin-Baier et al. Urol Case Rep. .

Abstract

Small bowel herniation underneath the iliac vessel after transperitoneal pelvic lymphadenectomy is a rare complication. This report describes the first case of bowel incarceration behind the external iliac artery after transperitoneal robotic-assisted radical prostatectomy with extended lymph node dissection in a patient with prostate cancer 1 year after surgery. After diagnosis on CT scan, an open resection of the ischemic bowel was performed. Because of thrombosis, the external iliac artery was opened, the clot was removed and the elongated artery was resected with end-to-end anastomosis. In case of a meandering iliac artery, a retroperitonealization after pelvic lymphadenectomy might be discussed.

Keywords: Complication; Internal hernia; Lymphadenectomy; Robotic-assisted radical prostatectomy.

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Figures

Figure 1
Figure 1
CT showing an internal hernia (arrow points) underneath the external iliac artery (arrow).
Figure 2
Figure 2
Incarcerated small bowel (arrow points) underneath the meandering external iliac artery (arrow).
Figure 3
Figure 3
Elongated external iliac artery after resection of the small bowel.
Figure 4
Figure 4
Anastomosis of the external iliac artery after resection of the 2 cm elongated part.
See this image and copyright information in PMC

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