Unusual presentation of trocar site hernia after Roux-en-Y gastric bypass: case report.
BACKGROUND
The exponential increase of bariatric surgery has resulted in a new diagnostic field of postoperative complications. One of the possibly serious complications is trocar site hernia.


METHODS
We present a rare case of trocar site hernia, in particular herniation of the blind loop of the jejunojejunostomy in a patient previously operated for laparoscopic gastric bypass.


CONCLUSIONS
In patients with intermittent epigastric pain and regurgitation or nausea after RYGB, the differential diagnosis should include internal herniation and cholecystitis. Besides that, incarcerated trocar site hernia should also be considered. If obstructive symptoms are lacking, this might indicate Richter's hernia or herniation of the blind loop of the jejunojejunostomy. Due to the vague symptoms and the potentially late presentation, diagnosis can be challenging. However, this is a dangerous complication possibly leading to bowel strangulation and perforation, requiring urgent surgical repair.
a Department of General Surgery , General Hospital Sint-Vincentius Deinze , Ghent , Belgium.|b Department of Gynaecology and Obstetrics , University Hospital Ghent , Ghent , Belgium.
Nele
N
Loret
a Department of General Surgery , General Hospital Sint-Vincentius Deinze , Ghent , Belgium.|c Department of Gastrointestinal Surgery , University Hospital Ghent , Ghent , Belgium.
Marieke
M
De Visschere
a Department of General Surgery , General Hospital Sint-Vincentius Deinze , Ghent , Belgium.
Luc
L
Berwouts
D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006555:Hernia, Ventral / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D000069290:Incisional Hernia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013525:Surgical Instruments / Q000009:adverse effects*
Bariatric surgery; blind loop; incisional hernia; postoperative complications