A Case of Strangulated Intrapericardial Herniation of the Small Bowel following Pericardial-Peritoneal Window

Hironori Kunisue, Shuji Ichihara, Shuichi Nomura, Tomohiro Nogami, Hideaki Mori, Yu Ohtani, Norihiro Ishido, Tetsuya Ohta, Yoshiyuki Usui and Shinichiro Tanaka

Department of Surgery, NHO Okayama Medical Center

We report a rare case of strangulated intrapericardial herniation of the small bowel following establishment of a pericardial-peritoneal window. A 96-year-old woman, in whom a pericardial-peritoneal window was established 5 months before for persistent pericardial effusion, developed sudden intense abdominal pain and was admitted to the hospital. Abdominal computed tomography revealed a segment of the small bowel in the pericardium. As strangulated intrapericardial hernia of the small bowel was suspected, emergent laparotomy was performed. A 30 cm segment of the small bowel was strangulated by the pericardial window, and was necrotic. Partial resection of the small bowel was performed and the window was covered by the round ligament of liver and closed. The postoperative course was good and the patient was discharged on the 24th postoperative day.

Key words
intrapericardial hernia, strangulated ileus, pericardial-peritoneal window

Reprint requests
Hironori Kunisue Department of Surgery, NHO Okayama Medical Center
1711-1 Tamasu, Okayama, 701-1192 JAPAN

Accepted
July 23, 2008

To read the PDF file you will need Abobe Reader installed on your computer.