Computed tomography findings of internal hernia after gastric bypass that may precede small bowel obstruction

Hernia ◽  
2015 ◽  
Vol 20 (3) ◽  
pp. 471-477 ◽  
Author(s):  
J. Park ◽  
M. Chung ◽  
J. Teixeira ◽  
J. Baer ◽  
D. Frager
Keyword(s):  
Computed Tomography ◽  
Gastric Bypass ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia

scholarly journals P-B03 Gastric Band Tubing Causing Small Bowel Obstruction

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Kashif Halim ◽  
Ana Lee ◽  
Stephen Odogwu ◽  
Amir Khan
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Gastric Banding ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Closed Loop ◽  
Gastric Band ◽  
Laparoscopic Gastric Banding ◽  
Gastric Bands

Abstract Background Laparoscopically adjustable gastric bands (LAGB) have been widely employed as a means of weight loss in bariatric surgery over the past two decades. Although now largely superseded by other bariatric surgical techniques, complications from gastric bands continue to be encountered in surgical practice. We report an unusual case of small bowel obstruction due to an internal hernia caused by gastric band tubing resulting in closed loop small bowel obstruction. This is  not  commonly encountered and emergency general surgeons need to have a high index of suspicion for this condition as a possible cause for small bowel obstruction. Methods A 40 year old male presented with abdominal pain, vomiting and failure to open bowels or pass flatus for nine days. Twelve years previously (2008) he had had Roux n Y gastric bypass (RYGB), followed by by laparoscopic gastric banding of the RYGB about two years later (2010) also in the private sector. He had a soft but distended abdomen, and empty rectum on rectal examination. CT scan abdomen reported as: Multiple loops of distended small bowel demonstrated. No air seen in rectum, indicative of small bowel obstruction. No pneumoperitoneum. There is dilatation of the mid and distal small bowel seen to an apparent transition point in the mid abdomen where a loop is noted associated with the tubing for the inflation device for the gastric band. This appears to be centred on the cause of obstruction and appears tied around the base of mesentery and may be creating a closed loop obstruction, by having created an internal hernia. This patient had an internal hernia around  loop of the gastric band tubing with resultant closed loop small bowel obstruction. The patient underwent diagnostic laparoscopy with ileo-caecal resection and primary anastomosis. He made successful recovery. Deflated gastric band remains in-situ. Results While small bowel obstruction is most commonly due to adhesions in individuals who have had previous laparotomy, it is important to bear in mind other causes such as internal hernias particularly in cases of those with history of previous gastric banding or Roux n Y gastric bypass. Early intervention may be necessary to reduce the  likelihood of bowel ischaemia and bowel resection. Laparoscopy is a useful tool in the management of small bowel obstruction. Keywords: gastric band, small bowel obstruction, closed loop, emergency surgery, laparoscopy Conclusions Connection tubing causing small bowel obstruction and colonic erosion as a rare complication after laparoscopic gastric banding: a case report. Liza BK Tan, Jimmy BY So, and Asim Shabbir - J Med Case Reports. 2012; 6: 9.  Acute small bowel obstruction due to the connecting tube of a gastric band. Federico Oppliger, M.D. Gonzalo Wiedmaier, M.D. Juan. Published April 07 2017. https://doi.org/10.1016/j.soard.2014.03.021 An unusual complication of gastric banding: recurrent small bowel obstruction caused by the connecting tube. M A Zappa, E Lattuada, E Mozzi, M Francese, I Antonini, S Radaelli, G Roviaro. Obes Surg . 2006 Jul;16(7):939-41.  doi: 10.1381/096089206777822250 Total small bowel herniation through the space between the connecting tube of gastric band and abdominal wall: A case report of a surgical emergency. Tarek Hashem, Soliman M Soliman, Sherif Wagih 2. Int J Surg Case Rep. 2017;30:66-68.  doi: 10.1016/j.ijscr.2016.11.021.  Epub 2016 Nov 17

Computed Tomography Patterns in Small Bowel Obstruction after Open Distal Gastric Bypass

2004 ◽  
Vol 14 (6) ◽  
pp. 811-822 ◽  
Author(s):  
Myur S. Srikanth ◽  
Thomas Keskey ◽  
S. Ross Fox ◽  
Ki Hyun Oh ◽  
Earl R. Fox ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gastric Bypass ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Distal Gastric Bypass

scholarly journals Internal hernia with Roux loop gangrene in a post

2019 ◽  
Vol 6 (8) ◽  
pp. 2995
Author(s):  
Swaminathan Ganesan ◽  
Satish Devakumar
Keyword(s):  
Gastric Bypass ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Laparoscopic Exploration ◽  
Internal Hernias ◽  
Elective Repair ◽  
High Degree

High degree suspicion is mandatory in dealing with a post-operative patient presenting with a crampy postprandial abdominal pain, as potential for internal hernias remains fairly under diagnosed. Except in setting of small bowel obstruction or gangrene and radiological proven internal hernia, intervening a patient with herald symptoms is still debatable, though certain authors advocate that in lap. Roux-en Y gastric bypass patients with herald symptoms should promptly be offered elective laparoscopic exploration elective repair safely and expeditiously.

Taxonomy and Imaging Spectrum of Small Bowel Obstruction After Roux-en-Y Gastric Bypass Surgery

2010 ◽  
Vol 194 (1) ◽  
pp. 120-128 ◽  
Author(s):  
Abhijit Sunnapwar ◽  
Kumaresan Sandrasegaran ◽  
Christine O. Menias ◽  
Mark Lockhart ◽  
Kedar N. Chintapalli ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery
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