Internal hernias due to gastric bypass surgery

Dr Henry Knipe and Dr Bruno Di Muzio et al.

Internal hernias due to gastric bypass surgery are more common after laparoscopic gastric bypass than after an open procedure. 

It is a particularly sinister complication with variable, nonspecific clinical presentations. Most patients report a combination of postprandial abdominal pain, nausea and emesis 1.

It has been suggested that patients are more prone to internal hernias after laparoscopic Roux-en-Y gastric bypass than after an open operation because there are fewer adhesions to tether small-bowel loops and prevent them from herniating. In addition, patients who have greater degrees of weight loss after laparoscopic Roux-en-Y gastric bypass may be more prone to internal hernia because of loss of the protective, space-occupying effect of mesenteric fat 1

Laparoscopic Roux-en-Y gastric bypass surgery produces three potential sites for internal hernia formation: 

  • at the defect in the transverse mesocolon through which the Roux limb passes (if it is placed in the retrocolic position)
  • at the mesenteric defect at the enteroenterostomy
  • behind the Roux limb mesentery placed in a retrocolic or antecolic position (retrocolic Petersen and antecolic Petersen type) 1
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Article information

rID: 14022
Section: Gamuts
Synonyms or Alternate Spellings:

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