Case Report: an Unusual Complex Internal Hernia After Roux-en-Y Gastric Bypass

Excerpt

Roux-en-Y gastric bypass (RYGB) has been proved to be an effective procedure for morbid obesity and metabolic disorders [1‐3]. The complications associated with RYGB include bleeding, anastomotic ulcer, anastomotic leakage, anastomotic stricture, intestinal obstruction, and malnutrition [4‐6]. Bowel obstruction is a relatively common postoperative complication following the RYGB procedure. The main causes of obstruction are internal hernias through Peterson’s or mesenteric defect and anastomotic stenosis [7]. Complete intestinal obstruction is rare but results in severe complications after RYGB. Emergency operation is warranted when complete, strangulated internal hernia leading to intestinal obstruction has been diagnosed. Here, we presented a case of intestinal obstruction secondary to an unusual complex internal hernia combined with jejuno-jejunal stricture, presented at several years after RYGB. In addition, we highlighted the three specific clinical signs and tricks in the operative approach of managing such disorder. …