چکیده (انگلیسی):

After reduction of the incarceration during surgery for incarcerated hernia, intestinal blood flow (IBF)
and the need for bowel resection must be evaluated. We report the case of a patient with incarcerated
umbilical hernia in whom the bowel was preserved after evaluating IBF using indocyanine green (ICG)
fluorescence. A woman in her 40s with a chief complaint of abdominal pain visited our hospital, was
diagnosed with incarcerated umbilical hernia and underwent surgery. Laparotomy was performed to
reduce bowel incarceration. After reducing the incarceration, IBF was observed using ICG fluorescence
detected using a brightfield full-color fluorescence camera. The small bowel that had been incarcerated
showed deep-red discoloration on gross evaluation, but intravenous injection of ICG revealed uniform
fluorescence of the mesentery and bowel wall. This indicated an absence of irreversible ischemic changes
of the bowel, so no resection was performed. The patient showed a good postoperative course, including
resumption of eating on day 4 and discharge on day 11. In surgery for incarcerated hernia, ICG fluorescence
may offer a useful method to evaluate IBF after reducing the incarceration. This case implied
that PINPOINT could be used in open conventional surgery.