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All Journal JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Indonesian Journal of Cancer
Prakosa, Yovan Indra Bayu
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health

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Incarcerated Pelvic Floor Peritoneal Hernia After Abdominoperineal Resection (APR): How To Prevent? Prakosa, Yovan Indra Bayu; Setyawan, Nurcahya; Yushinta, Milleninda Pasca
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1218

Abstract

Introduction: Colorectal cancer is the third most common cancer worldwide. One of the procedures that is often performed in cases of distal rectal cancer is abdominoperineal resection (APR) procedure that leaves the pelvic cavity with an empty space. This condition increases the possibility of pelvic floor peritoneal hernia. We present a rare case of this condition and provide information regarding prevention and treatment.Case Presentation: A male, 74 years old, with recurrent constipation following APR, was retrospectively analyzed. Abdominal CT scan 6 months after surgery showed no residual tumor. On final arrival, he came with typical signs of total small bowel obstruction. Abdominal x-ray results showed signs of small bowel obstruction. The results of the operation found an incarcerated pelvic floor peritoneal hernia. The surgical procedures performed were entrapment release and hernia repair with a peritoneal flap. Complaint of obstruction sign improved two days postoperatively.Conclusion: Pelvic floor peritoneal hernias should not be forgotten in patients who experience recurrent constipation in postoperative APR. Recurrent constipation is caused by a herniation of the small bowel in the hernia sac. Chronic constipation should be considered an abnormal cause of obstruction. Poor wound healing processes cause the neck of the hernia to narrow and cause an incarcerated hernia. Closure of the pelvic floor needs to be restored post-operatively
Ileocolonic transposition in an HIV patient with an esophageal stricture: A case study Handaya, Adeodatus Yuda; Andrew, Joshua; Susilo, Naufal Caesario Jouhari; Subroto, Polycarpus David; Azriel Farrel Kresna Aditya; Prakosa, Yovan Indra Bayu; Arianda, Daldy; Tyanti, Belvia Adelaida Maiya
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 16, No 1, (2025)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol16.Iss1.art14

Abstract

Introduction: Esophageal strictures in patients with HIV (Human immunodeficiency virus) are poorly understood in terms of pathogenesis, prevalence, incidence, and surgical management. Case Presentation: This case study is a 50-year-old man who has had trouble swallowing for ten months, which has left him unable to swallow for the past nine months. Clinical examination revealed thoracic esophageal constriction ranging from Vertebra thoracal (VTh) 4-5. Endoscopic findings revealed a convoluted, constricted lumen that impeded scope passage. A contrast-enhanced computed tomography (CT) scan on eight months ago revealed esophageal constriction, with suspicions of tuberculoma and fibrosis in the right upper lung. Reactive HIV results prompted anti-HIV therapy, supported by fine needle aspiration biopsy (FNAB) results, which demonstrated no evidence of malignancy but indicated granulomatous inflammation. Preoperative evaluations, including negative interferon-gamma release assay (IGRA) and sputum Acid-Fast Bacilli (AFB) tests, cleared the way for a three-hour ileocolonic transposition procedure. The procedure involved median and substernal incisions, dissection of the terminal ileum and the right colon as a graft, retrosternal tunnelling, and anastomosis with cervical oesophagus, which resulted in positive outcomes. A week later, the patient reported increased comfort, recovered eating and drinking abilities, and successful surgical incision healing. Conclusion: The ileocolonic transposition appears to be a potential therapeutic option. This safe and effective alternative not only addresses dysphagia but also improves the overall quality of life.
Co-Authors Adeodatus Yuda Handaya Andrew, Joshua Arianda, Daldy Azriel Farrel Kresna Aditya Nurcahya Setyawan Subroto, Polycarpus David Susilo, Naufal Caesario Jouhari Tyanti, Belvia Adelaida Maiya Yushinta, Milleninda Pasca