title: Petersen hernia after open gastrectomy with Roux-en-Y reconstruction: a report of two cases and literature review.
abstract: Petersen hernia is a rare internal hernia that occurs after Roux-en-Y (R-Y) reconstruction. To our knowledge, there are a few reports on internal hernia, especially Petersen hernia after open gastrectomy for gastric cancer. Two rare cases of Petersen hernia are presented in this report. A man in his 70s was referred to our hospital due to a complaint of postprandial sudden abdominal pain. He had a history of open total gastrectomy with R-Y jejunal reconstruction through the antecolic route for gastric corpus cancer. On computed tomography (CT), bowel obstruction and strangulation of the small intestine were suspected. Emergency laparotomy was done, and an internal herniation of the small intestine through Petersen space was observed. A man in his 50s was referred to our hospital due to a complaint of severe sudden abdominal pain. He had a history of open gastrectomy and abdominal/lower intrathoracic esophageal resection with R-Y jejunal reconstruction of an antecolic jejunal limb for esophagogastric junction carcinoma. On CT, internal herniation of the small intestine was suspected. During emergency laparotomy, an internal herniation of the bowel through the Petersen space was observed. Though history of R-Y reconstruction surgery may be helpful, preoperative diagnosis of Petersen hernia is difficult to establish. Here we present two rare cases of this type of internal hernia.
authors.affiliation: Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Baba
authors.affiliation: Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Yamazoe
authors.affiliation: Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.affiliation: Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Okuyama
authors.affiliation: Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Mogami
authors.affiliation: Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kobashi
authors.affiliation: Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nozawa
authors.affiliation: Department of Radiology, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Aoyagi
authors.affiliation: Department of Surgery, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Fujisaki
authors.affiliation: Department of Surgery, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ogura
authors.affiliation: Department of Surgery, Tokyo Dental College Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba 2728513 Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsui
keywords: Gastric cancer; Internal hernia; Petersen hernia; Roux-en-Y reconstruction