Role of CT imaging in discriminating internal hernia from aspecific abdominal pain following Roux-en-Y gastric bypass: a single high-volume centre experience

2020 ◽  
Vol 72 (4) ◽  
pp. 1115-1124 ◽  
Author(s):  
Veronica Bordonaro ◽  
Maria Gabriella Brizi ◽  
Francesca Lanza ◽  
Pierpaolo Gallucci ◽  
Amato Infante ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Abdominal Pain ◽  
Internal Hernia ◽  
High Volume ◽  
Ct Imaging

scholarly journals Roux-En-Y By-Pass Ressection Due to Intestinal Ischemia

2021 ◽  
Vol 6 (3) ◽  
Keyword(s):  
Gastric Bypass ◽  
Abdominal Pain ◽  
Obesity Surgery ◽  
Surgical Procedures ◽  
Internal Hernia ◽  
Intestinal Ischemia ◽  
Intestinal Transit ◽  
Emergency Laparotomy ◽  
Ischemic Area ◽  
Primary Surgery

Obesity surgery is one of the most commonly performed surgical procedures today and laparoscopy has become the preferred technique for Roux-en-Y gastric bypass. A patient transferred to the surgery service for an abdominal pain had an abdominal tomography performed which demonstrated an aspect suggestive of internal hernia. Underwent emergency laparotomy. Resection of the ischemic area was performed. Reconstruct intestinal transit was madded 4 days after primary surgery. In this case, the complete ischemia of the Bypass segment has become a challenge to reconstruct the transit.

scholarly journals Petersen’s Space Internal Hernia after Laparoscopic One Anastomosis (Mini) Gastric Bypass

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Mohammad Kermansaravi ◽  
Mohammad Kazazi ◽  
Abdolreza Pazouki
Keyword(s):  
Gastric Bypass ◽  
Abdominal Pain ◽  
Internal Hernia ◽  
Signs And Symptoms ◽  
Mini Gastric Bypass ◽  
Complete Obstruction ◽  
Intermittent Abdominal Pain ◽  
Equal Zero ◽  
Case Summary ◽  
Exploratory Laparoscopy

Background. One anastomosis gastric bypass (OAGB) is now considered as an appropriate alternative for Roux-en-Y gastric bypass (RYGB) with some advantages such as absence of risk for internal hernia (IH). But, is really the risk of IH equal zero after OAGB? Case Summary. A 37-year-old male was admitted due to severe abdominal crampy pain, nausea, vomiting, and obstipation. He had chronic and intermittent abdominal pain from 2 years after OAGB. With high suspicion of complete obstruction, the exploratory laparoscopy was performed. Intraoperative findings showed incarcerated bowel hernia from Petersen’s defect. The incarcerated bowel was reduced, and the defect was repaired. The patient was discharged 2 days after operation. Conclusion. The incidence of IH after OAGB is rare but not zero. In any suspicious signs and symptoms for IH, the early exploratory laparoscopy is mandatory to diagnose and treat.

scholarly journals Abdominal Pain after Gastric Bypass: Labor, Uterine Rupture, or Obstruction and Internal Hernia

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Sarah N. Cross ◽  
Unzila Nayeri ◽  
Andrew Duffy ◽  
Christian M. Pettker
Keyword(s):  
Gastric Bypass ◽  
Abdominal Pain ◽  
Internal Hernia ◽  
Preterm Labor ◽  
Gastrointestinal Pathology ◽  
Treatment Of Obesity ◽  
Prolonged Hospital ◽  
Reproductive Aged Women ◽  
Emergent Laparotomy ◽  
Surgical Treatment Of Obesity

Background. Although gastric bypass may reduce obesity-related complications of subsequent pregnancies, surgical complications requiring antenatal and postpartum interventions are not uncommon.Case. A 26-year-old G4P1112 status post-Roux-en-Y gastric bypass required multiple urgent antenatal evaluations due to frequent episodes of abdominal pain. At 35 + 4 weeks, she presented with severe abdominal pain; initial evaluation was negative for gastrointestinal pathology. The patient was found to be in preterm labor and underwent a repeat cesarean section. The postoperative course was complicated by bowel obstruction due to internal hernia resulting in an emergent laparotomy and a prolonged hospital course.Conclusion. As more reproductive-aged women opt for surgical treatment of obesity, it is essential that obstetricians recognize complications to be able to counsel and appropriately care for these patients.

scholarly journals Internal Hernia After One Anastomosis Gastric Bypass (OAGB): Lessons Learned from a Retrospective Series of 3368 Consecutive Patients Undergoing OAGB with a Biliopancreatic Limb of 150 cm

2021 ◽  
Author(s):  
Niccolo Petrucciani ◽  
Francesco Martini ◽  
Radwan Kassir ◽  
Gildas Juglard ◽  
Celine Hamid ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Internal Hernia ◽  
Intestinal Resection ◽  
High Volume ◽  
Lessons Learned ◽  
One Anastomosis Gastric Bypass ◽  
Morbidity Rate ◽  
Specificity And Sensitivity ◽  
Biliopancreatic Limb ◽  
History Of

Abstract Background Internal hernia (IH) represents a relatively common and well-known complication after Roux-en-Y gastric bypass. IH after one anastomosis gastric bypass (OAGB) is less frequent and rarely reported in the literature. This study presents a series of IH after OAGB observed in a high-volume bariatric center. Methods Data of patients who underwent OAGB with an afferent limb of 150 cm between May 2010 and September 2019 were prospectively collected and retrospectively analyzed. Data of patients undergoing surgery for IH during follow-up were collected and analyzed. Results Ninety-six patients out of 3368 with a history of OAGB had intestinal incarceration in the Petersen’s orifice (2.8%). Specificity and sensitivity of computed tomography scans in the diagnosis of IH were 59% and 76%, respectively. The mean timeframe between OAGB and surgery for IH was 21.9±18.3 months. Mean body mass index at the time of IH surgery was 24.7 ± 3.6. Surgery was completed laparoscopically in 96.8% of cases. Nine patients (9.3%) had signs of bowel hypovascularization. In all patients, the herniated bowel was repositioned, and the Petersen’s orifice was closed, without the need for bowel resection. Mean hospital stay was 1.9 ± 4.8 days. The postoperative morbidity rate was 8.3%. Long-term IH relapse was observed in 14 patients; signs of bowel hypovascularization due to incarceration in a small orifice was observed in eight of these patients (57%). Conclusions Incidence of IH after OAGB is 2.8%. IH is associated with a low rate of bowel ischemia and the need for intestinal resection.

Diagnosis of Transmesocolic Internal Hernia as a Complication of Retrocolic Gastric Bypass: CT Imaging Criteria

2007 ◽  
Vol 189 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Suraj A. Reddy ◽  
Caroline Yang ◽  
Leslie A. McGinnis ◽  
Richard E. Seggerman ◽  
Ernesto Garza ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Internal Hernia ◽  
Ct Imaging

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.

Enterogastric Reflux: an Uncommon Diagnosis Analyzed by Hepatobiliary Imaging

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Peter Wang
Keyword(s):  
Abdominal Pain ◽  
Digestive Enzymes ◽  
Gallbladder Disease ◽  
Hepatobiliary Scintigraphy ◽  
Hepatobiliary Imaging ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Upper Abdominal ◽  
Enterogastric Reflux

Enterogastric reflux (EGR) is the reflux of bile and digestive enzymes from the small bowel into the stomach. While it is a normal physiologic process in small amounts, excessive reflux and chronic EGR can cause upper GI symptoms often mimicking more common diseases such as gallbladder disease and GERD that often leads to its underdiagnosis. Identifying EGR is significant as it has been associated with the development of gastroesophogeal pathology including gastritis, esophagitis, ulcers, and mucosal metaplasia. This article presents a 22-year-old male with enterogastric reflux causing upper abdominal pain and will discuss the role of hepatobiliary scintigraphy in its diagnosis.

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