I. Bulent Cetindag, MD1, Jane He, MD1, Hassan Imran, MD1, Jason Rexroth, MD2. 1University of Iowa / Mercy Medical Center, 2Mercy Medical Center
This is a video presentation of 51 years old female , who presented with suprapubic pain and mass to Gynecology office. She has a history of robotic hysterectomy and sbladder sling operation 4 years ago. This was complicated with peritonitis and long ICU stay , due to what she was called "bowel injury" but treated only conservatively with antibiotics and subsequent abscess drainages at that time. She has occasional appearing nodule and pain at the left suprapubic region. CT ordered by Gynecology read as abdominal wall hernia with long sigmoid diverticuli in hernia. Also there was small amount of subcutaneous air at the tip of herniated diverticuli.
After antibiotic treatment and improvement, colonoscopy shows, actually the diverticuli is the limb of the sling going through th esimoid and anchored in subcutaneous fat on abdominal wall ahich representsclocutaneous fistula as gets infected. Clip was placed on sling and repeat imaging comfirmed that the localion of this sling fits to location of so called "hernia"
The sling limb was resected robotically and colon was repaired with side stapling of clolonic wall. The abdominal wall defect is repaired with long term absorbable suture. As far as we have found, th epresentation and treatment of this complication is unique and could not find a similar case to guide us for the plan.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86822
Program Number: P813
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster