title: [Internal hernia following laparoscopic gastric bypass].
abstract: BACKGROUND
  Internal herniation following a laparoscopic Roux-en-Y gastric bypass (LRYGB) operation is a complication whereby the small bowel herniates through to the newly formed peritoneal compartment. Medical history, physical examination and laboratory tests are often non-specific and could lead to misdiagnosis.
  
  
  METHODS
  A 46-year-old male with a history of a gastric bypass came to the emergency department with colicky upper-abdominal pain. The patient was initially diagnosed with symptomatic cholelithiasis and a laparoscopic cholecystectomy was performed. However, the pain persisted and the internal hernia was finally identified and repaired during the third abdominal operation.
  
  
  CONCLUSIONS
  Internal herniation must be considered in patients with a history of laparoscopic Roux-en-Y gastric bypass and upper-abdominal pain, especially because such operations are being performed more frequently. When there is a high suspicion of internal herniation, a diagnostic laparoscopy must be performed and the entire small intestine must be systematically inspected.
authors: St. Antonius Ziekenhuis, afd. Heelkunde, Nieuwegein, the Netherlands.
authors: Arjen
authors: A
authors: Kolk
authors: Irene G
authors: IG
authors: Sportel
authors: Wouter W
authors: WW
authors: te Riele
authors: Eric J
authors: EJ
authors: Hazebroek
authors: Bert
authors: B
authors: van Ramshorst
authors: M J René
authors: MJ
authors: Wiezer
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D015390:Gastric Bypass / Q000009:adverse effects*; D006547:Hernia / Q000175:diagnosis / Q000209:etiology*; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome