Internal Hernia through a Congenital Peritoneal Defect in the Pouch of Douglas causing Small Bowel Obstruction

2020 ◽  
Vol 92 (3-4) ◽  
pp. 138-140
Author(s):  
C. Kounoudes ◽  
G. Veloudis ◽  
P. Katopodis ◽  
M. Malamas ◽  
Stavros Gourgiotis
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Pouch Of Douglas

Computed tomography findings of internal hernia after gastric bypass that may precede small bowel obstruction

Hernia ◽  
2015 ◽  
Vol 20 (3) ◽  
pp. 471-477 ◽  
Author(s):  
J. Park ◽  
M. Chung ◽  
J. Teixeira ◽  
J. Baer ◽  
D. Frager
Keyword(s):  
Computed Tomography ◽  
Gastric Bypass ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia

scholarly journals Small Bowel Obstruction Caused by an Internal Hernia in a Defect of an Ileocecal Fold

2018 ◽  
Vol 51 (11) ◽  
pp. 709-713
Author(s):  
Yasuko Matsuo ◽  
Satoru Akashi ◽  
Shiho Sugimori ◽  
Yukishige Yamada
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia

scholarly journals P-B03 Gastric Band Tubing Causing Small Bowel Obstruction

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Kashif Halim ◽  
Ana Lee ◽  
Stephen Odogwu ◽  
Amir Khan
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Gastric Banding ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Closed Loop ◽  
Gastric Band ◽  
Laparoscopic Gastric Banding ◽  
Gastric Bands

Abstract Background Laparoscopically adjustable gastric bands (LAGB) have been widely employed as a means of weight loss in bariatric surgery over the past two decades. Although now largely superseded by other bariatric surgical techniques, complications from gastric bands continue to be encountered in surgical practice. We report an unusual case of small bowel obstruction due to an internal hernia caused by gastric band tubing resulting in closed loop small bowel obstruction. This is  not  commonly encountered and emergency general surgeons need to have a high index of suspicion for this condition as a possible cause for small bowel obstruction. Methods A 40 year old male presented with abdominal pain, vomiting and failure to open bowels or pass flatus for nine days. Twelve years previously (2008) he had had Roux n Y gastric bypass (RYGB), followed by by laparoscopic gastric banding of the RYGB about two years later (2010) also in the private sector. He had a soft but distended abdomen, and empty rectum on rectal examination. CT scan abdomen reported as: Multiple loops of distended small bowel demonstrated. No air seen in rectum, indicative of small bowel obstruction. No pneumoperitoneum. There is dilatation of the mid and distal small bowel seen to an apparent transition point in the mid abdomen where a loop is noted associated with the tubing for the inflation device for the gastric band. This appears to be centred on the cause of obstruction and appears tied around the base of mesentery and may be creating a closed loop obstruction, by having created an internal hernia. This patient had an internal hernia around  loop of the gastric band tubing with resultant closed loop small bowel obstruction. The patient underwent diagnostic laparoscopy with ileo-caecal resection and primary anastomosis. He made successful recovery. Deflated gastric band remains in-situ. Results While small bowel obstruction is most commonly due to adhesions in individuals who have had previous laparotomy, it is important to bear in mind other causes such as internal hernias particularly in cases of those with history of previous gastric banding or Roux n Y gastric bypass. Early intervention may be necessary to reduce the  likelihood of bowel ischaemia and bowel resection. Laparoscopy is a useful tool in the management of small bowel obstruction. Keywords: gastric band, small bowel obstruction, closed loop, emergency surgery, laparoscopy Conclusions Connection tubing causing small bowel obstruction and colonic erosion as a rare complication after laparoscopic gastric banding: a case report. Liza BK Tan, Jimmy BY So, and Asim Shabbir - J Med Case Reports. 2012; 6: 9.  Acute small bowel obstruction due to the connecting tube of a gastric band. Federico Oppliger, M.D. Gonzalo Wiedmaier, M.D. Juan. Published April 07 2017. https://doi.org/10.1016/j.soard.2014.03.021 An unusual complication of gastric banding: recurrent small bowel obstruction caused by the connecting tube. M A Zappa, E Lattuada, E Mozzi, M Francese, I Antonini, S Radaelli, G Roviaro. Obes Surg . 2006 Jul;16(7):939-41.  doi: 10.1381/096089206777822250 Total small bowel herniation through the space between the connecting tube of gastric band and abdominal wall: A case report of a surgical emergency. Tarek Hashem, Soliman M Soliman, Sherif Wagih 2. Int J Surg Case Rep. 2017;30:66-68.  doi: 10.1016/j.ijscr.2016.11.021.  Epub 2016 Nov 17

scholarly journals Small bowel obstruction due to internal hernia through sigmoid epiploica

2019 ◽  
Vol 2019 (1) ◽  
Author(s):  
Eugene Wang ◽  
Ashley Humphries ◽  
Laura S Johnson
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia

scholarly journals Internal hernia - a rare cause of small bowel obstruction: a case report

2016 ◽  
Vol 4 (1) ◽  
pp. 427 ◽  
Author(s):  
Samir U. Rambhia ◽  
Premjeet Madhukar
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Previous History ◽  
Exploratory Laparotomy ◽  
Internal Hernias ◽  
Post Surgery ◽  
History Of ◽  
Acute Small Bowel Obstruction

Internal hernia means a protrusion into pouches or openings in the peritoneum or mesentry in contrast to the hernias through defects in the retaining walls of the abdomen. Internal hernias are of many varieties with different classifications and can be congenital or acquired post-surgery. We present a case of a 55 year old female who presented with symptoms of acute small bowel obstruction with previous history of exploratory laparotomy 20 years back for reasons not known to her. Routine blood investigations, chest and abdomen skiagram and a CECT abdomen were performed (which gave no significant clue to diagnosis) and after a failed conservative trial patient was taken for exploration. Intra operatively a gangrenous loop of small bowel was found herniating through a band between the small bowel mesentry and the sigmoid mesocolon, forming a closed loop obstruction. Resection anastomosis of the gangrenous segment along with band transection was performed. The post-operative course was uneventful. Internal herniation as a cause of bowel obstruction should always be kept in mind as a differential.

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