The most common causes for small-bowel obstructions with subsequent strangulation are intra-abdominal adhesions and external hernias. The occurrence of an internal hernia through a congenital or iatrogenic defect in the falciform ligament is extremely rare. However in the era of minimally invasive surgery, an increase in laparoscopic port related complications have been increasing.
Method and results:
We present an unusual case of small bowel obstruction after laparoscopic cholecystectomy. Diagnostic laparoscopy confirmed an internal herniation through falciform ligament with evidence of strangulation. The cause of the hernia was due to an epigastric port that went through both sides of the falciform ligament at the time of initial surgery. Patient underwent division of falciform ligament and reduction of the hernia and had an uncomplicated recovery.
The surgeon should consider dividing the inferior leaf of the free edge of the falciform ligament, including the round ligament, should an aperture be created during laparoscopic port placement.
Program Number: P145