A Case of Ileus due to Sciatic Hernia Treated with Conservative Therapy

Hiroaki Uchida, Hiroshi Kawasaki, Tsukasa Nishida, Kenji Umemoto, Kazuhiro Miyoshi, Yuki Inada*, Mitsuru Matsuki* and Takashi Ishibasi

Department of Gastroenterological Surgery and Department of Radiology*, Shiroyama Hospital

A 75-year-old woman presented in an emergency with abdominal pain, fever, and vomiting. A diagnosis of ileus due to sciatic hernia with incarceration of small-bowel was found in abdominal X-ray to have small-bowel dilation and in abdominal computed tomography (CT) to have an intestinal loop deviating from the abdominal cavity to the right sciatic foramen, yielding the patient was admitted after a long tube had been placed to decompress the bowel. Enterography using gastrografin through the long tube showed that small-bowel stenosis was not complete and gave no evidence of necrotic change due to strangulated hernia content. The 5 days after admission in conservative therapy without emergency surgery, woman's symptoms disappeared. She began oral feeding after the long tube was removed. The course after removing the long tube was uneventful, and she was hospitalized elsewhere on day 56 after admission. She has shown no further symptoms due to the sciatic hernia for more than 15 months. Sciatic hernia is very rare, 51 cases in the world literature, and, only 10 cases have been reported in Japan. We discuss our case in light of a review of the literature.

Key words
sciatic hernia, ileus

Reprint requests
Hiroshi Kawasaki Department of Gastroenterological Surgery, Shiroyama Hospital
2-8-1 Habikino, Habikino, 583-0872 JAPAN

Accepted
November 18, 2009

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