Internal Hernia in Pregnant Women After Gastric Bypass: a Retrospective Register-Based Cohort Study

Gudbrand, Charlotte; Andreasen, Lisbeth Anita; Boilesen, Astrid E. B.

doi:10.1007/s11695-015-1693-8

Cited by 36 publications

(20 citation statements)

References 14 publications

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“…Second, because the majority of the cases included in the literature review are derived from case reports, rather than cohort studies, publication bias may have played a role. The largest case series in the review 29 reported lower maternal and fetal morbidity than the overall systematic review.…”

Section: Discussionmentioning

confidence: 81%

Internal Herniation in Pregnancy After Gastric Bypass

Vannevel

Jans

Bialecka

et al. 2016

Obstetrics &Amp; Gynecology

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Section: Discussionmentioning

confidence: 81%

Internal Herniation in Pregnancy After Gastric Bypass

Vannevel

Jans

Bialecka

et al. 2016

Obstetrics &Amp; Gynecology

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“…A systematic review reported five neonatal and three maternal deaths and the necessity of acute surgical intervention in 20 cases in pregnancy with the majority of intervention due to internal hernia after RYGB [ 1 ]. Further, 23 women requiring urgent surgical intervention due to internal hernia but no death were reported in another study [ 65 ]. A recent case report describes acute bowel ischemia following thrombosis of the superior mesenteric artery in pregnant women after RYGB with loss of the fetus, several acute laparotomies, and subtotal enterectomy, preserving the first 20 cm of the jejunum [ 66 ].…”

Section: Resultsmentioning

confidence: 99%

Management of Pregnant Women after Bariatric Surgery

et al. 2018

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The prevalence of obesity is growing worldwide, and strategies to overcome this epidemic need to be developed urgently. Bariatric surgery is a very effective treatment option to reduce excess weight and often performed in women of reproductive age. Weight loss influences fertility positively and can resolve hormonal imbalance. So far, guidelines suggest conceiving after losing maximum weight and thus recommend conception at least 12–24 months after surgery. As limited data of these suggestions exist, further evidence is urgently needed as well for weight gain in pregnancy. Oral glucose tolerance tests for the diagnosis of gestational diabetes mellitus (GDM) should not be performed after bariatric procedures due to potential hypoglycaemic adverse events and high variability of glucose levels after glucose load. This challenges the utility of the usual diagnostic criteria for GDM in accurate prediction of complications. Furthermore, recommendations on essential nutrient supplementation in pregnancy and lactation in women after bariatric surgery are scarce. In addition, nutritional deficiencies or daily intake recommendations in pregnant women after bariatric surgery are not well investigated. This review summarizes current evidence, proposes clinical recommendations in pregnant women after bariatric surgery, and highlights areas of lack of evidence and the resulting urgent need for more clinical investigations.

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“…But with late diagnosis, strangulation is often, and can lead to large bowel resections or even need bowel transplant, situations involving high mortality 1 , 17 . This presentation is even more dramatic when it occurs in special situations, such as during pregnancy 10 , 14 .…”

Section: Discussionmentioning

confidence: 99%

Fixing Jejunal Maneuver to Prevent Petersen Hernia in Gastric Bypass

Murad-Junior

Scheibe

Campelo

et al. 2015

ABCD, arq. bras. cir. dig.

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Background: Among Roux-en-Y gastric bypass complications is the occurrence of intestinal obstruction by the appearance of internal hernias, which may occur in Petersen space or the opening in mesenteric enteroenteroanastomosis. Aim: To evaluate the efficiency and safety in performing a fixing jejunal maneuver in the transverse mesocolon to prevent internal hernia formation in Petersen space. Method: Two surgical points between the jejunum and the transverse mesocolon, being 5 cm and 10 cm from duodenojejunal angle are made. In all patients was left Petersen space open and closing the opening of the mesenteric enteroenteroanastomosis. Results: Among 52 operated patients, 35 were women (67.3%). The age ranged 18-63 years, mean 39.2 years. BMI ranged from 35 to 56 kg/m2 (mean 40.5 kg/m2). Mean follow-up was 15.1 months (12-18 months). The operative time ranged from 68-138 min. There were no intraoperative complications, and there were no major postoperative complications and no reoperations. The hospital stay ranged from 2-3 days. During the follow-up, no one patient developed suspect clinical presentation of internal hernia. Follow-up in nine patients (17.3%) showed asymptomatic cholelithiasis and underwent elective laparoscopic cholecystectomy. During these procedures were verified the Petersen space and jejunal fixation. In all nine, there was no herniation of the jejunum to the right side in Petersen space. Conclusion: The fixation of the first part of the jejunum to left side of the transverse mesocolon is safe and effective to prevent internal Petersen hernia in RYGB postoperatively in the short and medium term. It may be interesting alternative to closing the Petersen space.

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Internal Hernia in Pregnant Women After Gastric Bypass: a Retrospective Register-Based Cohort Study

Cited by 36 publications

References 14 publications

Internal Herniation in Pregnancy After Gastric Bypass

Internal Herniation in Pregnancy After Gastric Bypass

Management of Pregnant Women after Bariatric Surgery

Fixing Jejunal Maneuver to Prevent Petersen Hernia in Gastric Bypass

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