Internal hernias and gastric perforation after a laparoscopic gastric bypass

A 27-year-old woman underwent laparoscopic Rouxen-Y gastric bypass. A retrocolic-retrogastric herniation of most of the small bowel and later a gastric perforation due to internal hernia at the mesenteric defect of the jejuno-jejunostomy occurred. These unusual, but not rare, complications are directly related to the neoanatomy that follows gastric bypass and can lead to rapidly progressing and life-threatening situations. Proper evaluation of clinical signs and symptoms, early abdominal CT scan, and urgent operative intervention are mandatory to achieve a successful outcome.