Related Experiment Video
Updated: Jun 26, 2026
10:52
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
5.3K
Internal post-bariatric hernia due to hepatic adhesion: a case report
Bruno Mirandola Bulisani1,2, Murilo Rocha Rodrigues1, Luiz Guilherme Lisboa Gomes1,2
1RR Médicos Cirurgiões, São Bernardo do Campo, SP, Brazil.
Einstein (Sao Paulo, Brazil)
|September 20, 2023
Summary
Roux-en-Y gastric bypass can cause rare internal hernias. This case highlights a novel hernia location, emphasizing diagnostic challenges and the critical role of laparoscopy for timely intervention.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Bariatric Surgery
Background:
- Roux-en-Y gastric bypass (RYGB) is effective for obesity and metabolic disorders but carries risks like internal hernias.
- Internal hernias post-RYGB are challenging to diagnose and can lead to fatal bowel obstruction.
- Common hernia sites include jejunojejunostomy and Petersen's spaces.
Observation:
- A 36-year-old woman presented with symptoms suggestive of internal hernia after RYGB.
- An uncommon internal hernia was identified between the liver and the alimentary loop, creating a new space.
- This hernia incarcerated the entire biliopancreatic loop, a previously unreported location.
Findings:
- The internal hernia was not detected by standard abdominal and pelvic CT scans.
- Diagnostic laparoscopy was crucial in identifying the hernia, formed by adhesions between hepatic segment III and the alimentary loop mesentery.
- Prompt surgical intervention via laparoscopy prevented further patient complications.
Implications:
- This case expands the understanding of rare internal hernia locations following RYGB.
- It underscores the limitations of conventional imaging in diagnosing certain internal hernias.
- Highlights the indispensable role of diagnostic laparoscopy in managing complex post-RYGB complications.
Related Concept Videos
01:26Diseases of the Liver and Gallbladder
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
01:21External Anatomy of the Kidney
The kidneys are a pair of bean-shaped organs in the human body that play a critical role in maintaining overall health. They filter out waste products from the blood, regulate blood pressure, maintain electrolyte balance, and stimulate the production of red blood cells.
The kidneys are located in the retroperitoneal space on either side of the vertebral column, protected posteriorly by the 11th and 12th ribs. The right kidney sits slightly lower than the left owing to the presence of the liver...
The kidneys are located in the retroperitoneal space on either side of the vertebral column, protected posteriorly by the 11th and 12th ribs. The right kidney sits slightly lower than the left owing to the presence of the liver...
01:24Chronic Pancreatitis I: Introduction
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:25Acute Pancreatitis I: Introduction
Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
01:25Chronic Pancreatitis I: Introduction
Chronic pancreatitis is a long-standing, relapsing inflammation of the pancreas, characterized by irreversible damage to the gland. It results in progressive destruction of the pancreatic parenchyma, fibrosis, and eventual loss of both exocrine and endocrine function. The disease may evolve gradually after multiple episodes of acute pancreatitis or develop independently.EtiologyChronic pancreatitis can arise from a variety of causes:Alcohol use is the leading cause, accounting for 70–80% of...