Luis Zavala, SURGEON, Carlos Adrian Espinosa, Buenaventura Leal, SURGEON, Abel Salazar, Fernando Gurrola. CENTRO DE OBESIDAD Y DIABETES
Introduction: In the last decades, the laparoscopic roux-y gastric bypass (LRYGP), has become one of the most used bariatric procedures, thanks to its eficiency in weight lost and metabolic control. But there could be complications, such as internal hernias, either through the Petersen space or the mesenteric gap.
The incidence of internal hernias after a LRYGB without closure of the Petersen space, or mesenteric gap is low, about 3-6 %
We havent found in the literatura a case report of a double internal hernia.
Objetive: To report a rare complication of LRGB, which must be diagnosed and treated in a timely manner, to improve the outcome
Case report: We present a case o a female patient, with history of a LRYGB 3 years ago. 4 days before her admission, she started with abdominal pain, difuse, exacerbated with food intake, partially atenuated adopoting left lateral decubitus. 24 hours previous to her admission pain intensity increases. The plain abdominal film showed distenden small bowel loop and they were filled with fluid and intraluminal air. She underwent a diagnostic laparoscopy, finding a doble internal hernia , in mesenteric gap and petersen space, without vascular compromise, the hernias were reduce and the defects were closed with 2-0 vascular prolene.
Results: Surgery time of 20 min. The diet was started 4 hours after the procedure, she was discharged next day after surgery.
Conclusion: We must suspect an internal hernia in all patients with andominal pain. Diagnostic laparoscopy is a great method for diagnose and treatment. A proper closure of the gaps during bariatric procedures shlould be made, to prevent future complications.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79384
Program Number: P629
Presentation Session: Poster (Non CME)
Presentation Type: Poster