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A case of repeated internal hernia after Roux-en-Y reconstruction following laparoscopic distal gastrectomy Tomohiro OSAKI 1 , Naoki HIKI 1 , Souya NUNOBE 1 , Shinya TANIMURA 1 , Takeshi SANO 1 , Toshiharu YAMAGUCHI 1 1Department of Gastroenterological Surgery, Cancer Institute Hospital Keyword: 腹腔鏡下胃切除 , Roux-en-Y再建 , 内ヘルニア , Petersen裂孔 pp.619-624
Published Date 2011/10/15
DOI https://doi.org/10.11477/mf.4426100691
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 The patient was a 71 year-old man with abdominal pain with a past history of laparoscopic distal gastrectomy (LDG) with an ante-colic Roux-en-Y (RY) reconstruction for gastric cancer. Abdominal computed tomography of the small intestine showed a whirling appearance, and the patient was diagnosed as having internal hernia or torsion of the small intestine. Emergency laparotomy under general anesthesia revealed the entire small intestine was strangulated in the right side of the Petersen hiatus. We released the strangulated small intestine, and sutured to close the hiatus. Four months later, the operation was repeated as the hiatus re-opened, and an inner hernia recurred. There are few reports of internal hernia after LDG for gastric cancer. We should recognize that internal hernia is a serious complication after LDG with RY reconstruction. In addition, it is important that the hiatus is correctly sutured to prevent the internal hernia from recurring.


Copyright © 2011, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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