{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:20:41Z","timestamp":1786119641637,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2011,1,1]],"date-time":"2011-01-01T00:00:00Z","timestamp":1293840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T00:00:00Z","timestamp":1373932800000},"content-version":"vor","delay-in-days":927,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>We report a case of small bowel obstruction with strangulation caused by a port site hernia following a laparoscopic appendicectomy and the successful management of the problem by employing a laparoscopy assisted technique. The aim of this report is to emphasize the importance of fascial closures of trocar sites in order to significantly decrease postoperative morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report:<\/jats:title>\n                    <jats:p>\n                      A 31 years old female presented with a classic clinical picture of acute appendicitis. She underwent an uneventful laparoscopic appendicectomy. A 12 mm trocar was used at the umbilical port. On Postoperative day three, the patient developed abdominal distension, crampy abdominal pain, nausea and bilious vomiting. Her white cell count increased to 16,500\/mm\n                      <jats:sup>3<\/jats:sup>\n                      , and CRP was 145. X-ray abdomen showed dilated small bowel with multiple air fluid levels. CT scan showed a herniated loop of small bowel into the trocar site with small bowel obstruction. Laparoscopy was done to confirm the Richter\u2019s hernia into trocar site with small bowel obstruction. The bowel loop could not be reduced laparoscopically. Limited exploration of the trocar site confirmed findings with necrosis of the antimesenteric portion of the small bowel. A limited bowel resection and anastomosis was performed. The patient had an uneventful recovery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Most port site hernias present within 10 days of the primary procedures, delayed hernias have been reported. CT scan is a helpful adjunct to differentiate port site hematoma from incarcerated small bowel. The knowledge of such a complication and its early diagnosis are important to avoid complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2010.11.002","type":"journal-article","created":{"date-parts":[[2010,11,24]],"date-time":"2010-11-24T04:50:45Z","timestamp":1290574245000},"page":"9-11","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Laparoscopic port site Richter\u2019s hernia \u2013 An important lesson learnt"],"prefix":"10.1097","volume":"2","author":[{"given":"Ashwin","family":"Rammohan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.M.","family":"Naidu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-4-20260114","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/PL00012281","article-title":"Risks of the minimal access approach for laparoscopic surgery: multivariate analysis of morbidity related to umbilical trocar insertion","volume":"21","author":"Mayol","year":"1997","journal-title":"World J Surg"},{"key":"R2-4-20260114","first-page":"674","article-title":"Small bowel incarceration after uncomplicated laparoscopy","volume":"43","author":"Schiff","year":"1974","journal-title":"Obstet Gynaecol"},{"key":"R3-4-20260114","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1136\/bmj.2.6099.1393","article-title":"Small intestinal obstruction from a Richter\u2019s hernia at the site of insertion of a laparoscope","volume":"2","author":"Bourke","year":"1977","journal-title":"Br Med J"},{"key":"R4-4-20260114","first-page":"881","article-title":"Incisional hernias following laparoscopy: a survey of the American Association of Gynecologic Laparoscopists","volume":"84","author":"Montz","year":"1994","journal-title":"Obstet Gynecol"},{"key":"R5-4-20260114","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1007\/s004649901135","article-title":"Incisional hernias after laparoscopic vs open cholecystectomy","volume":"13","author":"Sanz-Lopez","year":"1999","journal-title":"Surg Endosc"},{"key":"R6-4-20260114","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1001\/archsurg.139.11.1248","article-title":"Trocar site hernia","volume":"139","author":"Tonouchi","year":"2004","journal-title":"Arch Surg"},{"key":"R7-4-20260114","doi-asserted-by":"crossref","first-page":"6881","DOI":"10.3748\/wjg.14.6881","article-title":"Strangulated small bowel hernia through the port site: a case report","volume":"14","author":"Lee","year":"2008","journal-title":"World J Gastroenterol"},{"key":"R8-4-20260114","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1046\/j.1365-2508.1996.3050470.x","article-title":"Richters hernia following operative laparoscopy.","volume":"5","year":"1996","journal-title":"Gynaecol Endosc"},{"key":"R9-4-20260114","first-page":"187","article-title":"Port site hernia: a rare complication of laparoscopy","volume":"64","author":"Rao","year":"2008","journal-title":"MJAFI"},{"key":"R10-4-20260114","first-page":"64","article-title":"Early port site hernia causing small bowel obstruction after laparoscopic appendicectomy","volume":"7","author":"Abdel-Halim","year":"2007","journal-title":"Grand Rounds"},{"key":"R11-4-20260114","doi-asserted-by":"crossref","first-page":"891","DOI":"10.2214\/ajr.164.4.7726042","article-title":"Distinction between postoperative ileus and mechanical bowel obstruction: value of CT compared with clinical and other radiographic findings","volume":"164","author":"Frager","year":"1995","journal-title":"AJR"},{"key":"R12-4-20260114","first-page":"9","article-title":"Soft-tissue images. Trocar-site hernia after laparoscopic procedures","volume":"45","author":"Cadeddu","year":"2002","journal-title":"Can J Surg"},{"key":"R13-4-20260114","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1381\/096089202321019684","article-title":"Laparoscopic repair of access port site hernia after Lap-Band system implantation","volume":"12","author":"Susmallian","year":"2002","journal-title":"Obes Surg"},{"key":"R14-4-20260114","first-page":"181","article-title":"Port-site closure: a new problem, an old device","volume":"6","author":"Di Lorenzo","year":"2002","journal-title":"JSLS"},{"key":"R15-4-20260114","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1089\/lap.1999.9.135","article-title":"Laparoscopic surgery complications associated with trocar tip design: review of literature and own results","volume":"9","author":"Leibl","year":"1999","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R16-4-20260114","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1089\/lap.1999.9.455","article-title":"Comparison of wounds created by non-bladed trocars and pyramidal tip trocars in the pig","volume":"9","author":"Kolata","year":"1999","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R17-4-20260114","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1177\/000313480006600911","article-title":"Laparoscopic port sites do not require fascial closure when nonbladed trocars are used","volume":"66","author":"Liu","year":"2000","journal-title":"Am Surg"},{"key":"R18-4-20260114","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1007\/s00464-006-9095-6","article-title":"Port closure techniques","volume":"21","author":"Shaher","year":"2007","journal-title":"Surg Endosc"},{"key":"R19-4-20260114","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1177\/1553350608318789","article-title":"Prevention of trocar site hernias: description of the safe port plug technique and preliminary results","volume":"15","author":"Moreno-Sanz","year":"2008","journal-title":"Surg Innov"},{"key":"R20-4-20260114","first-page":"3","article-title":"Laparoscopic Port Site hernia at a 12 mm non-bladed ethicon endopath Excel VersaStep\u2122 trocar site","volume":"2","author":"Patel","year":"2010","journal-title":"World J Colorectal Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261210000337?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261210000337?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/01612930-201102010-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T18:38:35Z","timestamp":1786041515000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01612930-201102010-00004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,1]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2010.11.002","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2011,1]]}}}