A rare case of internal hernia, intussusception and volvulus following gastric bypass: A case report and literature review

Elkbuli, Adel; Santarone, Kristen; Kinslow, Kyle; McKenney, Mark; Boneva, Dessy

doi:10.1016/j.ijscr.2020.01.060

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…Internal hernias are the main causes of intestinal obstruction and must always be considered in the differential diagnosis [3]. Intestinal intussusception has also been described after bariatric surgery [1,3].…”

Section: Discussionmentioning

confidence: 99%

Intestinal obstruction following gastric bypass

Geist

Mottin

Dillenburg

et al. 2021

Obesity Research & Clinical Practice

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Section: Discussionmentioning

confidence: 99%

Intestinal obstruction following gastric bypass

Geist

Mottin

Dillenburg

et al. 2021

Obesity Research & Clinical Practice

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“…The most common IH sites following RYGB include: 1) the transmesocolic window (when a transmesocolic Roux limb is fashioned), which is surrounded by the incised transverse mesocolon, thus allowing passage of the ascending Roux limb; 2) Petersen's window (or retro-alimentary limb space), which is defined by the transverse mesocolon posteriorly and the mesojejunum of the Roux limb anteriorly, and is located just caudally to the Roux limb's passage through the transmesocolic window (if one exists); 3) the mesojejunal window (or Brolin's space), which is defined by the mesojejunum of the biliopancreatic limb lying anteriorly and the mesojejunum of the Roux limb lying posteriorly; and 4) the jejuno-jejunal window, which is located between the Roux limb and the distal part of the biliopancreatic loop [23][24][25][26] (Figures 1-3). Complex hernias and hernias concomitant with volvulus and intussusception have also been described [19,27,28].…”

Section: Epidemiology and Pathophysiology Of Internal Hernia Post-rygbmentioning

confidence: 99%

Hernia as a Complication of Metabolic Bariatric Surgery

Pantelis,

Bhandari

2023

Hernia Updates and Approaches

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Metabolic Bariatric Surgery (MBS) is increasingly gaining ground, given that it constitutes the most effective treatment of obesity and associated health problems, with enduring results and a well-documented safety profile. Nevertheless, certain issues may rise in the medium and long term. Among them, there is a heterogeneous group of complications under the umbrella term “post-bariatric hernia”, including internal hernias, abdominal wall hernias, and hiatal hernias. Internal hernias constitute the most studied category, but evidence on the other categories is not lacking. This chapter will attempt to cover diagnostic, treatment, and preventive aspects in the management of hernia post-MBS following a comprehensive, evidence-based approach. In brief, with regards to the prevention of internal hernias, suturing of all defects is strongly recommended for Roux-en-Y Gastric Bypass (RYGB), but the evidence is less clear when it comes to newer bypass procedures, such as One-Anastomosis/Mini Gastric Bypass (OAGB/MGB) and Single Anastomosis Duodenal-Ileal Bypass (SADI). As far as abdominal wall hernias are concerned, there is no clear evidence of the advantages of suture closure against non-closure. Finally, with respect to hiatal hernias post-MBS, the caveat rests in the documentation of de novo versus pre-existing hiatal hernia, which mandates meticulous preoperative evaluation of symptoms and potentially further endoscopic documentation.

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“…The most susceptible seemed to be women who had successful weight loss [ 13 , 16 ]. The woman in Michiels et al's study had RYGB for class III obesity in 2015; in the two years following the procedure, she had lost more than 50 kg, and her BMI had dropped from 43.7 to 25.1 kg/m 2 [ 14 ].…”

Section: Reviewmentioning

confidence: 99%

“…In post-RYGB patients diagnosed with intussusception, no lead point is identified during surgical exploration, and all intussusceptions involve the jejunojejunostomy site, more often in a retrograde fashion and occasionally in an anterograde fashion [ 21 ]. Elkbuli et al and Doño et al also stated that intussusception most commonly occurs at the jejunojejunostomy site in a retrograde fashion in post-RYGB patients [ 11 , 16 ]. Most intussusceptions are retrograde but can be anterograde.…”

Section: Reviewmentioning

confidence: 99%

“…For cases that have been documented, the median period at presentation is 36 weeks after surgery [ 2 ]. The studies by Chys et al, Michiels et al, and Elkbuli et al reported that the patient just presented with abdominal pain solely [ 13 , 14 , 16 ]. Doño et al reported that the patient presented with worsening abdominal pain with pain radiation to the flank: 10/10 on the pain scale associated with nausea and constipation [ 11 ].…”

Section: Reviewmentioning

confidence: 99%

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Intussusception and Gut Dysmotility: A Systematic Review Assessing Unexpected Complications of Bariatric Surgery

Shergill,

Boppana,

Almansouri

et al. 2024

Cureus

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Bariatric surgery, although effective in treating obesity-related comorbidities, rarely results in intussusception, which is a severe complication. This study aimed to enhance clinical practice and establish early diagnosis by elucidating risk factors and management strategies associated with intussusception. We conducted this systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 criteria. We looked through PubMed, PubMed Central, ScienceDirect, ScienceOpen, MyScienceWork, Hyper Articles en Ligne (HAL), Google Scholar, and the Medical Literature Analysis and Retrieval System Online for relevant studies and research. Articles were screened according to inclusion and exclusion criteria, and relevance. We employed pertinent quality appraisal instruments to look for bias. Initially, we discovered 2,833 items. We eliminated redundant and unnecessary publications. After reviewing all the articles, we selected 30 studies based on their titles and abstracts. Out of the 30 studies reviewed, 12 papers were included in this review, with the remaining 18 being eliminated due to low quality. Medical practitioners and surgeons have a responsibility to meticulously monitor and provide postoperative surveillance, with a particular emphasis placed on individuals exhibiting symptoms of abdominal pain and vomiting, as there is a clinical imperative to consider the possibility of intussusception. The management approach, whether conservative or surgical, remains contingent upon the clinical context.

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A rare case of internal hernia, intussusception and volvulus following gastric bypass: A case report and literature review

Cited by 7 publications

References 19 publications

Intestinal obstruction following gastric bypass

Intestinal obstruction following gastric bypass

Hernia as a Complication of Metabolic Bariatric Surgery

Intussusception and Gut Dysmotility: A Systematic Review Assessing Unexpected Complications of Bariatric Surgery

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