1. Multiple Internal Hernias: A Complication of Laparoscopic Roux-en-Y Gastric Bypass.
- Author
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Samuelson AG, Damron LF, Haddadin Z, Adnan SM, and Neff M
- Subjects
- Female, Humans, Middle Aged, Anastomosis, Roux-en-Y adverse effects, Retrospective Studies, Internal Hernia complications, Abdominal Pain complications, Vomiting complications, Gastric Bypass adverse effects, Hernia, Abdominal diagnosis, Laparoscopy adverse effects
- Abstract
Introduction: Internal hernias are the most common cause of small bowel obstruction following laparoscopic Roux-en-Y gastric bypass surgery (LRYGBP) with four distinct types. Herein, we report the clinical course of a patient with two independent hernias at the Petersen's space and a rarer subtype at the jejunojejunal window. A high index of suspicion for less common subtypes of internal hernias and the possibility of multiple, simultaneous internal hernias is critical., Case Description: We describe the case of a 52-year-old female with a history of LRYGBP who presented with abdominal pain and emesis due to an internal hernia at Peterson's defect, requiring subsequent laparoscopic repair. On postoperative day three, the patient presented again with recurrent abdominal pain and emesis. Repeat exploratory laparoscopy found a separate internal hernia involving the jejunojejunal window with the previously repaired Petersen's defect intact., Discussion: This case illustrates a unique scenario of a patient post-LRYGBP with multiple internal hernias at the Peterson's space and the less common jejunojejunal window, which was missed during the index surgery. Failure to identify simultaneous hernias may result in additional invasive intervention and further morbidity., Conclusion: Multiple less-common variants of internal hernias may present simultaneously following LRYGBP., Competing Interests: Conflict of interests: none., (© 2023 by SLS, Society of Laparoscopic & Robotic Surgeons.)
- Published
- 2023
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