A Case of Strangulation Ileus by a Ureteric Band following Hysterectomy

Abstract

A 32-year-old woman with a previous history of undergoing laparoscopic hysterectomy for cervical cancer was admitted to our hospital because of abdominal pain and vomiting. She had a peritoneal irritation sign in the right lower quadrant of abdomen. Abdominal contrast-enhanced computed tomography showed the distended small intestine with a closed loop and the dilated right ureter which had interrupted at the right lower quadrant. An emergency surgery was performed with the diagnosis of strangulation ileus. Operative findings included a loop of necrotic small intestine obstructed by a constricting band crossing the right pelvic cavity. The band was suspected to be the right ureter, but the strangulation was severe. We had to cut the band to reduce the strangulation and performed segmental resection of the small intestine. The band was proved to be the right ureter, and a repair of the ureter was performed. It was considered that the small intestine invaginated in the back side of the right ureter which was isolated during previous laparoscopic hysterectomy. As we encountered an extremely rare case of strangulation ileus with a ureteric band after gynecologic surgery, we report this case here, with a review of the literature.