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Background <p>Internal hernias<!--Query ID="Q1" Text="Please check if article title was captured and presented correctly. " Resolved="yes"--> after pelvic lymphadenectomy are rare, but can cause small bowel obstruction and serious vascular complications.</p> Case Presentation <p>A<!--Query ID="Q2" Text="Please confirm if the author names are presented accurately and in the correct sequence. Otherwise amend if necessary. " Resolved="yes"--> woman in her early forties with prior endometrial cancer surgery presented with two weeks of progressive abdominal pain, distension, and right lower limb edema. Contrast-enhanced CT revealed herniation<!--Query ID="Q3" Text="Please check if affiliations were captured and presented correctly. " Resolved="yes"--> of small bowel loops through a peritoneal defect between the right external iliac artery (EIA) and the pelvic wall, with right external iliac vein compression and thrombosis. After preoperative inferior vena cava (IVC) filter placement, emergency laparotomy confirmed viable bowel herniated beneath the external iliac vessels. The hernia was reduced, the defect was closed with nonabsorbable sutures, and pelvic reconstruction was performed. The patient had an uneventful recovery. At three months, Doppler ultrasonography showed partial recanalization of the right external iliac vein without recurrence.</p> Conclusions <p>Surgeons should<!--Query ID="Q4" Text="Please check Abbreviations if captured and presented correctly. " Resolved="yes"--> be aware of this rare complication. Early recognition and multidisciplinary management are crucial for favorable outcomes.</p>

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Internal herniation beneath the external iliac vessels with deep vein thrombosis following pelvic lymphadenectomy: a rare cause of bowel obstruction

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月27日

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  • Chao Qiang Shi,
  • Xin Du,
  • Chao Fang

摘要

Background

Internal hernias after pelvic lymphadenectomy are rare, but can cause small bowel obstruction and serious vascular complications.

Case Presentation

A woman in her early forties with prior endometrial cancer surgery presented with two weeks of progressive abdominal pain, distension, and right lower limb edema. Contrast-enhanced CT revealed herniation of small bowel loops through a peritoneal defect between the right external iliac artery (EIA) and the pelvic wall, with right external iliac vein compression and thrombosis. After preoperative inferior vena cava (IVC) filter placement, emergency laparotomy confirmed viable bowel herniated beneath the external iliac vessels. The hernia was reduced, the defect was closed with nonabsorbable sutures, and pelvic reconstruction was performed. The patient had an uneventful recovery. At three months, Doppler ultrasonography showed partial recanalization of the right external iliac vein without recurrence.

Conclusions

Surgeons should be aware of this rare complication. Early recognition and multidisciplinary management are crucial for favorable outcomes.