Small Bowel Strangulation under External Iliac Vessels after Robot-Assisted Prostatectomy.

Introduction: Internal herniation under the external iliac vasculature is a rare cause of small bowel obstruction, however an increasing number of cases have been reported in recent years.

Presentation of the case: We report a case of 74-year-old male patient who presented with diffuse abdominal pain. He had undergone robot-assisted laparoscopic prostatectomy 4 months earlier. Computed tomography showed signs of internal herniation under the right external iliac vessels. The patient was operated laparoscopically with small bowel resection and peritoneal flap.

Conclusion: Internal herniation under external iliac vessels is a rare and challenging condition. Operation can be performed well with both laparotomy and laparoscopy. We suggest closing peritoneal defects during index operation and strongly recommend defect closure after an episode of internal herniation.