Internal Hernia and Small Bowel Obstruction After Roux-en-Y Gastric Bypass
Gastric bypass (RYGB) is considered the gold standard for bariatric surgical procedures. Small bowel obstruction (SBO) after gastric bypass is not uncommon; the internal hernia is the most common etiology followed by adhesions.
Internal hernia can be life-threatening; hence, it is crucial to diagnose and treat it early. Diagnosis can really be challenging, and it entails using different imaging techniques, as well as physical exam.
The management of internal hernia after RYGB remains surgical. The urgency of surgical intervention relies on the clinical condition of the patient. A diagnostic laparoscopy is indicated if clinical suspicion is high enough. An attempt at the time of original operation to reduce these potential complications is important. Closure of peritoneal and mesenteric defects and antecolic positioning of the Roux limb seem to decrease the percentage of internal hernia and other causes of SBO.
KeywordsGastric bypass Intestinal obstruction Internal hernia Mesenteric hernia
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