Late sigmoid colon internal herniation into the jejuno-jejunostomy mesenteric defect after laparoscopic Roux-en-Y gastric bypass.
A 49-year-old female with morbid obesity (BMI 42) underwent laparoscopic Roux-en-Y gastric bypass (LRYGBP). 10 months after the operation, she presented to the hospital with intermittent mid-abdominal pain. An internal hernia of the sigmoid colon through a mesenteric defect of the jejuno-jejunostomy was found. Although small bowel internal herniation has been widely documented, the finding of large bowel internal herniation has not been previously reported. Maintaining a high index of suspicion and a low threshold for urgent intervention are required when evaluating patients with vague abdominal complaints after LRYGBP.
Department of Surgery, Sound Shore Medical Center of Westchester, New Rochelle, NY, USA. rowdavi@yahoo.com
David
D
Row
Sridevi
S
Maddineni
Leonard
L
Maffucci
Madhu
M
Rangraj
D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D015992:Body Mass Index; D012809:Colon, Sigmoid / Q000503:physiopathology / Q000601:surgery; D003108:Colonic Diseases / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D046449:Hernia, Abdominal / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007582:Jejunostomy; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D018570:Risk Assessment