IPEG 2020 Top Abstract: Laparoscopic Left Mesocolic Hernia Repair

September 30, 2020
Presenter: Phillip B Ham, MD, MS

Phillip B Ham, MD, MS; Nicholas Georgalas, MD; Kathryn Bass, MD, MBA; Oishei Children's Hospital

Purpose: Left mesocolic hernias are congenital internal hernias that most commonly present in adulthood and have historically been treated mostly with open repair. We report a case of a pediatric patient who underwent laparoscopic repair.

Case Presentation: A 15 year old male presented with sudden acute abdominal pain and bilious vomiting, with a history of chronic abdominal pain. Imaging was concerning for an internal hernia despite no history of surgery. He underwent diagnostic laparoscopy with laparoscopic repair of a left mesocolic (paraduodenal) hernia. He did well postoperatively and was discharged postoperative day two.

Discussion: While there are only a few reports of laparoscopic approaches for left mesocolic hernias in children, it allows for confirmation of diagnosis and effective treatment with minimal morbidity. Early discharge is feasible with this approach as well as excellent pain control and cosmesis.

Conclusion: Laparoscopic left mesocolic hernia repair in pediatric patients is a safe and effective approach that may offer less morbidity, pain, and earlier discharge than an open approach.

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