Case Of Internal Herniation Research Articles

Medium-Term Outcomes from a Series of 1000 One Anastomosis Gastric Bypass in Australia: A Case Series.

This study presents the short- (less than 6months) and medium-term (6months to 2years) outcomes for weight loss and type 2 diabetes mellitus (T2DM) for all patients undergoing one anastomosis gastric bypass (OAGB) across multiple institutions between 2015 and 2021. A retrospective analysis of prospectively collected databases was performed including 1022 participants who underwent OAGB at multiple institutions by multiple surgeons between 2015 and 2021. Primary outcome was percentage total weight loss (TWL) and secondary outcomes were achieving resolution of T2DM; OAGB specific short- and medium-term complications including bile reflux, marginal ulceration and internal herniation. One thousand and twenty-two patients underwent OAGB (81% primary surgery). A percentage of 34.1% (n = 349) had a preoperative diagnosis of type 2 diabetes mellitus (T2DM). Mean TWL was 33.6 ± 9% with a T2DM remission rate of 74% at 1-year post-op. Rates of bile reflux and marginal ulceration was 1.1% (n = 11) and 1.1% (n = 11). There were no cases of internal herniation during the follow-up period. OAGB results has echoed previously published work as being efficacious and safe in a short-medium term. The prevalence of complications, especially bile reflux is overall low in our population and no current evidence exists to support an increased risk of metaplasia or malignancy related to bile within the stomach.

Internal Hernia After Laparoscopic Left Colectomy: Case Series and Review of the Literature

Abstract Objective Laparoscopic colectomy has gained acceptance as a standard treatment for benign and malignant colorectal disease, such as diverticular disease and cancer, among others. Same as in open surgery, the laparoscopic approach carries a low risk of small bowel obstruction in the postoperative period, but in laparoscopic surgery, internal hernia after laparoscopic left colectomy may be a cause of small bowel obstruction with a significant risk of morbidity and mortality. This rare complication may be prevented with routine closure of the mesenteric defects created during the colectomy. Methods We present four cases of internal herniation after laparoscopic colectomy. Two cases were after laparoscopic left colectomy and two after laparoscopic low anterior resection. All four cases had full splenic flexure mobilization. Routine closure of the mesenteric defect was not performed in the initial surgery. Results The four patients were treated by laparoscopic reintervention with closure of the mesenteric defect. In two of them, conversion to open surgery was necessary. One of the patients developed recurrent internal herniation after surgical reintervention with mesenteric closure of the defect. All patients were managed without need for bowel resection, and mortality rate was 0%. Conclusion Internal herniation after laparoscopic colorectal surgery is a highly morbid complication that requires prompt diagnosis and management and should be suspected in the early postoperative period. Additional studies with extended follow-up are required to establish recommendations regarding its prevention and management.

Pregnant patients with internal hernia after gastric bypass: a single-center experience.

Bariatric surgery has been a popular way for many women to reach a healthy body mass index, and as a consequence, a decreased body mass, which causes a greater chance of fertility, with improved pregnancy and better maternal outcomes. Describe a single-center experience of pregnancies complicated by internal hernias after gastric bypass. Academic Medical Center. During 2011 and 2019 a series of patients were treated for internal hernia after gastric bypass at our teaching hospital. The hospital records were retrospectively reviewed. Seven women were treated. Median age was 33 years (range: 24-39 yr). Median gestational age was 25.6 weeks (range: 5-33 wk). Median time from Roux-en-Y gastric bypass to pregnancy was 4 years (range: 1-7 yr). Median body mass index was 24 kg/m2 (range: 24-31 kg/m2). Five (71.4%) patients underwent an exploratory laparotomy, and 2 (28.5%) patients a diagnostic laparoscopy. In all patients, an internal hernia of the small bowel in the Petersen space was encountered. Median length of pregnancy was 38 weeks (range: 33.6-39.6 wk). Six (85.7%) patients underwent C-section, and 1 (14.2%) patient gave birth by vaginal delivery. There was only 1 maternal postoperative complication and no fetal postoperative complications. Median follow-up was 9 months (range: 2-20 mo). The rapid growth in bariatric surgery on obese women of fertile age could result in more cases of internal herniation during pregnancy in the future. An internal hernia should be suspected when encountering a postgastric bypass pregnant patient with abdominal pain, nausea, and vomiting.

Small bowel obstruction due to internal herniation of jejunum through a congenital defect in the falciform ligament in a primigravida

Small bowel obstruction due to internal herniation of jejunum through a congenital defect in the falciform ligament is a rare occurrence. Literature search shows not more than 14 cases of internal herniation of the small bowel through a congenital defect of the falciform ligament; and there are no reports of challenges faced in the diagnosis of herniation in pregnant patients. Here, we describe a rare case of internal hernia which posed significant diagnostic dilemma as the patient was 20 weeks primigravida. With restriction on the use of imaging tools, diagnosis of small bowel obstruction due to internal herniation through the falciform ligament was done by combining clinical findings with magnetic resonance imaging (MRI) and laparoscopy. The intestinal obstruction was resolved laparoscopically. The recovery was uneventful and the patient was discharged on postoperative day 4. The diagnosis of internal hernia as a cause of intestinal obstruction is usually difficult especially in the pregnant patient. However, careful examination and appropriate investigations will suggest the diagnosis which if promptly treated would be attended by a satisfactory outcome.

Herniated mobile descending colon

Persistent descending mesocolon is a congenital anomaly that has been shown, in most cases, to be asymptomatic because of its short length. To the best of our literature review and knowledge, no case of internal herniation of the mobile descending colon into either gastrocolic or splenocolic recesses have been reported. We therefore wish to report a case of herniated mobile descending colon in a middle-aged woman. HA was a 54-year-old female with a 2-year history of recurrent episodes of left upper quadrant pain of the abdomen. The pain, which was initially dull aching, suddenly became sharp in nature and so severe that it precluded her from doing her domestic activities. She had undergone clinical evaluation and work up previously but no etiology for her pain was found. After resuscitation, she consented to exploratory laparatomy for an acute on-chronic abdominal pain of unknown etiology. The intraoperative findings were a portion of the wall of the left colon seen to have herniated into a small band of tissue on the left posterior wall. The whole descending colon was unattached to the posterior peritoneum. The trapped portion (4 cm in length) of the wall of the colon was released and a warm pack was applied to the segment of large bowel so released. Following this maneuver, the portion was found to be viable and so a left colopexy was performed and the adhesion band that was placed obliquely from the spleen toward the midline was excised. Postoperative period was uneventful and since then the patient's abdominal pain has been abated over the past 1 year. The morbidity of a mobile descending colon includes internal herniation. Therefore, early detection and colopexy is necessary.

An Unusual Case of Right Transmesocolic Hernia with Ureter at the Neck of Sac

The purpose of the present article is to present an unusual case of internal herniation. In this case small bowl obstruction was due to congenital right trans-mesocolic hernia which had the right ureter at the neck of the sac forming a constriction band. This requires careful widening of neck of hernia, so as to avoid iatrogenic trauma to ureter. This unusual presentation needs dissemination as this type of internal hernia is extremely rare.

Incarcerated internal hernia of the small intestine through a re-approximated peritoneum after a trans-abdominal pre-peritoneal procedure—apropos of two cases: review of the literature

A description of two cases of internal herniation caused by a defect in the closure of the peritoneal flap during a trans-abdominal pre-peritoneal procedure is presented here. They were both successfully treated laparoscopically. This rare condition should be considered when patients who have had recent trans-abdominal surgery for inguinal hernia repair present with colicky lower abdominal pain--its aetiology may well be due to technical error. It is already established that laparoscopy is useful as a diagnostic and therapeutic tool in emergency cases, but it is also true that it is useful in case of early post-operative period complications following any laparoscopic procedure, such as the laparoscopic inguinal hernia repair.

A Case of Internal Herniation Through a Mesenteric Defect after Laparoscopy-Assisted Colectomy for Transverse Colon Cancer

A Case of Internal Herniation Through a Mesenteric Defect after Laparoscopy-Assisted Colectomy for Transverse Colon Cancer

子宮広間膜異常裂孔に生じた内ヘルニアの２例

子宮広間膜異常裂孔に生じた内ヘルニアの２例