Characteristics of Internal Hernia After Gastrectomy with Roux-en-Y Reconstruction for Gastric Cancer

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2014 Jan 9

PMID 24399525

Citations 19

Authors

Kozo Yoshikawa

Mitsuo Shimada

Nobuhiro Kurita

Hirohiko Sato

Takashi Iwata

Jun Higashijima

Motoya Chikakiyo

Masaaki Nishi

Hideya Kashihara

Chie Takasu

Noriko Matsumoto

Syohei Eto

Affiliations

Soon will be listed here.

Abstract

Background: Although the internal hernias have been a huge topic in the field of bariatric surgery, there were a few reports in gastric cancer. The purpose of this study was to analyze the incidence, clinical features, and prevention of internal hernia after gastrectomy for gastric cancer.

Methods: Twelve patients who underwent surgical treatment for internal hernia in our hospital after gastrectomy were analyzed. Features, including incidence, symptoms, and signs, were investigated in detail.

Results: The operative procedures for preceding gastrectomies were open distal gastrectomy in three patients, open total gastrectomy in three patients, laparoscopic-assisted distal gastrectomy in two patients, and laparoscopic total gastrectomy in four patients. The most frequent sites of internal hernias were jejunojejunostomy mesenteric defects (five patients) and Petersen's defect (five patients), mesenterium of transverse colon (one patient), and esophagus hiatus (one patient). There was no significant difference between open and laparoscopic preceding gastrectomies. After closure of the mesenteric defect was introduced, no further internal hernias occurred. On CT examination, the whirl sign was present in ten patients on 3D images.

Conclusions: The present data suggest the importance of early recognition and treatment of internal hernia, as well as its prevention by closure of mesenteric defects.

Citing Articles

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Clinical features of internal hernia after gastrectomy for gastric cancer.

Ahn H, Lee S, Jeon T, Kim D, Choi C, Kim S J Minim Invasive Surg. 2022; 24(1):18-25.

PMID: 35601282 PMC: 8965976. DOI: 10.7602/jmis.2021.24.1.18.

Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report.

Yasuda T, Sakurazawa N, Kuge K, Omori J, Arai H, Kakinuma D World J Clin Cases. 2022; 10(1):323-330.

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A Modified Billroth-II with Braun Anastomosis in Totally Laparoscopic Distal Gastrectomy: Initial Experience Compared with Roux-en-Y Anastomosis.

Yalikun A, Aikemu B, Li S, Zhang T, Ma J, Zheng M Ann Surg Oncol. 2022; 29(4):2359-2367.

PMID: 34994886 DOI: 10.1245/s10434-021-11187-4.

Risk Factor and Surgical Outcome of Petersen's Hernia After Gastrectomy in Gastric Cancer.

Liu S, Hu Q, Song P, Tao L, Ai S, Miao J Front Oncol. 2021; 11:765509.

PMID: 34820331 PMC: 8606515. DOI: 10.3389/fonc.2021.765509.

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