Intraoperative real-time fluorescence angiography with indocyanine green for evaluation of intestinal viability during surgery for an incarcerated obturator hernia: a case report

Patient Safety in Surgery
Dimitra DaskalopoulouKonstantinos Zarras

Abstract

Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of ischaemic bowel can be challenging. In this case report we discuss intraoperative fluorescence angiography with indocyanine green (ICG) as an objective means of accessing bowel perfusion following hernia reduction. The case of a 92-year-old, caucasian, female patient presenting with symptoms of small bowel obstruction secondary to an incarcerated left sided obturator hernia is presented. An incarcerated segment of the small bowel was reduced during emergency laparoscopy. Intraoperative ICG fluorescence angiography revealed ischaemic changes in the normal appearing bowel, so that the involved segment was resected. The postoperative course was uneventful and the patient was discharged home safely on postoperative day seven. Intraoperative ICG fluorescence angiography provides an objective method of judging bowel perfusion and therefore represents a useful tool for assessing intestinal perfusion in patients with incarcerated hernia.

References

Oct 29, 2008·Hernia : the Journal of Hernias and Abdominal Wall Surgery·L HuntP Sagar
Apr 3, 2013·Hernia : the Journal of Hernias and Abdominal Wall Surgery·D C K NgM K W Li
Jan 1, 2013·Journal of Surgical Case Reports·Noel P LynchEmmet J Andrews
Aug 27, 2014·Journal of Surgical Case Reports·Michaela RamserChristian Andreas Nebiker
Mar 25, 2015·Annals of Surgical Oncology·Naoto NishigoriYoshiyuki Nakajima
Jun 12, 2016·Surgical Endoscopy·Jing LiuJie Chen
Nov 20, 2016·Asian Journal of Endoscopic Surgery·Shunjin RyuYutaka Suzuki
Feb 3, 2018·Hernia : the Journal of Hernias and Abdominal Wall Surgery·A KohgaK Suzuki

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Citations

Mar 20, 2020·Surgical Case Reports·Yuka FujimotoYukihiro Inomata
Aug 11, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·D SchizasK Kontzoglou
Apr 11, 2021·Annals of Vascular Surgery·Brandon SchwarteErik J Wayne

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