Petersen’s Space Hernia After Gastric Bypass in a Pregnant Patient

Milan Ernjakovic, MD, FRCSC, John Hagen, MD, FRCSC. University of Toronto, Humber River Regional Hospital, Toronto, Canada.

 

This video summarizes the case of a Petersen’s space hernia in a 27 weeks pregnant woman who presented 2 years after a laparoscopic gastric bypass.
An urgent exploratory laparoscopy was performed and the diagnosis of a Petersen’s hernia was confirmed.
Because of the risk of strangulation Petersen’s hernia after gastric bypass is dangerous and potentially life threatening.
Urgent exploratory laparoscopy plays a crucial role in diagnosing and managing Petersen’s hernias. The same approach should be taken in pregnant patients.

This video is also an example of emergency laparoscopy serving as a valuable and safe diagnostic and therapeutic modality during pregnancy.
It also includes most recent guidelines on laparoscopy in pregnancy published by SAGES. The guidelines are based on previously published data on utility of laparoscopy during pregnancy for urgent non-obstetrical surgical issues.
During initial development of laparoscopic surgery pregnancy was considered a contraindication to laparoscopy. As surgeons have gained more experience with laparoscopy and the published data showed safety and efficacy of laparoscopic surgery in pregnancy, laparoscopy has become the preferred treatment for many surgical diseases in gravid patients.
 

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