title: A Peterson's hernia and subsequent small bowel volvulus: surgical reconstruction utilizing transverse colon as a new Roux-en-Y limb - 1 case.
abstract: Peterson's hernia is an internal hernia that can occur after Roux-en-Y anastomosis. It often accompanies small bowel volvulus and is prone to strangulation. Reconstruction of intestinal continuity after massive small bowel resection in a patient who undergoes near total gastrectomy and Roux-en-Y anastomosis can be difficult. A 74-year-old man who had undergone a near total gastrectomy and Roux-en-Y gastrojejunostomy for stomach cancer presented with abdominal pain. The preoperative computed tomography showed strangulated small bowel volvulus. During the emergent laparotomy, we found a strangulated Peterson's hernia with small bowel volvulus. After resection of the necrotized intestine, we made a new Roux-en-Y anastomosis connecting the remnant stomach and the jejunum with a transverse colon segment. We were safely able to connect the remnant stomach and the jejunum by making a new Roux-en-Y anastomosis utilizing a transverse colon segment as a new Roux-limb by two stage operation.
authors.affiliation: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors.forename: Jae Seong
authors.initials: JS
authors.lastname: Jang
authors.affiliation: Department of Surgery, Seoul Medical Center, Seoul, Korea.
authors.forename: Dong Gue
authors.initials: DG
authors.lastname: Shin
keywords: Gastrectomy; Hernia; Roux-en-Y; Volvulus