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Related Experiment Video

Updated: Feb 19, 2026

Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
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Internal hernia after proximal gastrectomy with jejunal interposition.

Yuichi Takayama1, Yuji Kaneoka2, Atsuyuki Maeda2

  • 1Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki-shi, Gifu-ken, 503-8502, Japan. t-yuichi@rf6.so-net.ne.jp.

Updates in Surgery
|November 6, 2017
PubMed
Summary

Internal hernia (IH) is a rare complication after proximal gastrectomy with jejunal interposition (PG-JI). This study found a 5.6% incidence of IH, often presenting with abdominal pain and a CT whirl sign, requiring intervention in most cases.

Keywords:
Gastric cancerInternal herniaJejunal interpositionPetersenProximal gastrectomy

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Area of Science:

  • Gastrointestinal Surgery
  • Surgical Complications
  • Abdominal Imaging

Background:

  • Internal hernia (IH) is a known complication after certain gastric surgeries.
  • Reports of IH following proximal gastrectomy with jejunal interposition (PG-JI) are infrequent.
  • Understanding IH incidence and presentation after PG-JI is crucial for patient management.

Purpose of the Study:

  • To determine the incidence of internal hernia (IH) after proximal gastrectomy with jejunal interposition (PG-JI).
  • To analyze the clinical features and outcomes of patients who develop IH after PG-JI.

Main Methods:

  • Retrospective review of 71 patients undergoing PG-JI for gastric cancer.
  • Analysis of patient data from July 2007 to December 2016.
  • Median follow-up of 50 months to identify IH development.

Main Results:

  • Four patients (5.6%) developed internal hernia (IH) after PG-JI.
  • IH occurred in Petersen defects that were not closed, regardless of open or laparoscopic approach.
  • Abdominal pain and a CT whirl sign were consistent findings; 75% required bowel resection without morbidity.

Conclusions:

  • Internal hernia (IH) is a significant complication after proximal gastrectomy with jejunal interposition (PG-JI).
  • Clinical suspicion should be high for patients presenting with abdominal pain and a whirl sign on CT.
  • Consideration of mesenteric defect closure may reduce IH incidence post-surgery.