Drain site evisceration of fallopian tube, another reason to discourage abdominal drain: report of a case and brief review of literature

Abstract

Placement of a drain following abdominal surgery is common despite a lack of convincing evidence in the current literature to support this practice. The use of intra-abdominal drain is associated with many potential and serious complications. We report a drain site evisceration of the right fallopian tube after the removal of an intra-abdominal drain. The drain was placed in the right iliac fossa in a patient who underwent a lower segment Caesarean section (LSCS) for meconium liquor with fetal distress. The Pfannenstiel incision made for LSCS was reopened and the protruding inflamed fimbrial end of the right fallopian tube was excised. The patient made an uneventful recovery. Routine intra-abdominal prophylactic drain following an abdominal surgery including LSCS should be discouraged.

Abandoning the blind legacy passed on horde of routine intra-abdominal drain insertion in cesarean section

“…Our frightening and life threatening complication of Fallopian tube herniation was reported in 2 subjects of this study (1.6%) which harmonies with a previous case report published by Saint et al [6]. Drainage is undoubtedly associated with a huge psychological mal-being and anxiety especially for those who have it placed for longer periods.…”

Laparoscopic management of a drain site evisceration of the vermiform appendix, a case report

“…Drain site evisceration is a rare complication of abdominal cavity drainage. Many organs may eviscerate through: omentum, small bowel, fallopian tube, gallbladder or vermiform appendix [1] , [2] , [3] , [4] , [5] .…”

“…This complication is often immediate after removal of the drain, but it may occur several hours or even few days later [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , even years after wound healing a drain site hernia may occur.…”

“…Its management differed from a case to another. Some authors did respect the eviscerated appendix and pulled it back into the abdominal cavity through an enlarged incision which has been closed at the end of procedure, when others performed an appendectomy through the drain site, with or without enlargement of the hole under general or local anaesthesia [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] . However, the drain defect was not closed in all cases [6] , [7] , [8] , [9] , [10] .…”

Drain-Site Hernia Containing the Vermiform Appendix: Report of a Case

“…Moreover, even in the absence of complications, patients with intraperitoneal drainage failed to have outcomes superior to those without drains [6, 7]. A complication not to be underestimated is hernia formation after removal of the drain with early evisceration or later herniation of intestinal structures [8, 9]. Obviously, the risk for those complications correlates with the drain diameter which reflects the abdominal wall defect.…”