Retrogastric Hernia: An Unusual Cause of Intestinal Obstruction.

Alexander Ramirez Valderrama, MD, Litong Du, MD FACS. NEW YORK HOSPITAL QUEENS

Internal herniation is an unusal cause of intestinal obstruction. Herniation of the intestine may be through a normal anatomical apertura or an abnormal structure.
The incidence of internal hernia trough the lesser sac is very unusual, there are few reports on the literature. We present a case of a 53 year-old male with no significant past medical history who presented to emergency department for one day history of abdominal pain associated with nauseas and vomiting. The pain was severe and localized on the epigastrium and left upper quadrant. The patint got a abdominal CT scan that was consistent with small bowel obstruction and possible bowel ischemia. patient underwent to diagnostic laparoscopy and a large amount of ascitis and also necrotic bowel was noted in the left upper quadrant. at this time the procedure was converted to esploratory laparotomy and it was noted that the small bowel was incarcerated trough the lesser sac behind the stomach and necrotic small bowel was identified and resected. A primary anastomosis was done and the mesentery defect was closed with 3-0 vicryl. The patient had an unevenfull recovery from the procedure and the patient was discharge home without any complications