title: Dual incarcerated internal hernias after laparoscopic total gastrectomy with Roux-en-Y reconstruction for gastric cancer.
abstract: Internal hernia postgastrectomy is an exceedingly rare complication especially in the laparoscopic cohort of patients. Different types of internal hernias have been described, of which, Petersen's and jejunojejunostomy mesenteric defect hernias are the most commonly encountered followed by oesophageal defect and transverse colon mesocolic defect hernias. As the early presentation is always non-specific, late diagnosis of internal hernia has significant implication on morbidity and mortality. Here, we present a rare case of a patient with previous laparoscopy-assisted total gastrectomy presented with features of impending bowel obstruction and bowel ischaemia secondary to dual incarcerated internal hernias. We also reviewed the literature focusing on clinical features of internal hernia, essential CT findings and preventive measures.
authors.affiliation: Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Zi Qin
authors.identifier: http://orcid.org/0000-0002-6272-4640
authors.initials: ZQ
authors.lastname: Ng
authors.affiliation: Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Willy
authors.initials: W
authors.lastname: Low
authors.affiliation: Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Subramanian
authors.affiliation: Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Joel
authors.initials: J
authors.lastname: Stein
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D005743:Gastrectomy / Q000009:adverse effects*; D046449:Hernia, Abdominal / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery; D016896:Treatment Outcome