Internal Hernia with Roux Loop Obstruction during Pregnancy after Gastric Bypass Surgery |
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Authors: | Ahmed R Ahmed MD BSc MRCS William O'Malley MD FACS |
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Institution: | (1) Fellow in Bariatric and GI Surgery, University of Rochester Medical Center, Highland Hospital, Rochester, NY, USA;(2) Assistant Professor of Surgery, Director of Bariatric Center, University of Rochester Medical Center, Highland Hospital, Rochester, NY, USA |
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Abstract: | We report the rare case of a pregnant woman who had undergone Roux-en-Y gastric bypass 8 months previously, and now presented
with subacute small bowel obstruction secondary to internal herniation of some of the proximal Roux limb into the lesser sac
through the transverse mesocolon rent, which was widely spread apart. At laparoscopy, the hernia contents were reduced and
the defect was repaired. The patient made a good recovery. Because of the changes associated with pregnancy, gastric bypass
patients may be at an increased risk of internal herniation. It is particularly important not to delay surgical exploration,
even in the absence of a positive finding on imaging, because delay may lead to potentially devastating bowel strangulation
and sepsis culminating in loss of fetus and mother. |
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Keywords: | MORBID OBESITY GASTRIC BYPASS LAPAROSCOPY INTERNAL HERNIA PREGNANCY |
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