Inwendige herniatie na laparoscopische maagbypass

Background

Internal herniation following a laparoscopic Roux-en-Y gastric bypass (LRYGB) operation is a complication whereby the small bowel herniates through to the newly formed peritoneal compartment. Medical history, physical examination and laboratory tests are often non-specific and could lead to misdiagnosis.

Case description

A 46-year-old male with a history of a gastric bypass came to the emergency department with colicky upper-abdominal pain. The patient was initially diagnosed with symptomatic cholelithiasis and a laparoscopic cholecystectomy was performed. However, the pain persisted and the internal hernia was finally identified and repaired during the third abdominal operation.

Conclusion

Internal herniation must be considered in patients with a history of laparoscopic Roux-en-Y gastric bypass and upper-abdominal pain, especially because such operations are being performed more frequently. When there is a high suspicion of internal herniation, a diagnostic laparoscopy must be performed and the entire small intestine must be systematically inspected.

Conflict of interest: none declared. Financial support: none declared.