J Korean Surg Soc.  2011 Jan;80(1):72-75. 10.4174/jkss.2011.80.1.72.

Retroanastomotic Hernia

• Park SY
• Chung M

• KMID: 2096623
• DOI: http://doi.org/10.4174/jkss.2011.80.1.72

Abstract

Gastric surgery is one of the most frequently performed operations in Korea. Retroanastomotic hernia is a rare complication ingastric surgery. We experienced this hernia and herein report it with a review of the literature. A 69-year-old male patient suffered from periumbilical pain for 3 days. Positive physical findings were tenderness around the umbilicus and decreased bowel sound. Simple abdominal findings revealed a mechanical obstruction. This patient had a history of gastrectomy 13 years prior to admission. At operation field, we were able to find the defect consisting of the transverse mesocolon, stomach, jejunum and retroperituneum. In Korea, since its first report by Petersen, only a few reports about this hernia have been reported. After increased incidence of operations for morbid obesity, reports on retroanstomotic hernia have increased.

Keyword

Retroanstomotic hernia; Mechanical obstruction

MeSH Terms

Aged
Gastrectomy
Hernia
Humans
Incidence
Jejunum
Korea
Male
Mesocolon
Obesity, Morbid
Stomach
Umbilicus

Figure

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  Fig. 1. Abdominal CT scan shows dilated peripheral small bowel loops and edematous small bowel loops at left side of abdomen with layered mesenteries.

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  Fig. 2. This photograph shows internally herniated small bowel with dark red color and dilated small bowel loops. (A) Transverse colon. (B) Efferent loop of gastrojejunostomy.

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  Fig. 3. This photograph shows reducted state and Petersen's defect (between arrows). (A) Transverse colon. (B) Efferent loop of gastrojejunostomy.

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  Fig. 4. The different sites for internal hernia after Roux-en-Y gastric bypass surgery (retrocolic reconstruction). (A) Behind Roux limb. (B) Jejunojejunostomy site. (C) Mesocolic. In case of antecolic reconstruction, there is no mesocolic site.

Reference

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