Superior mesenteric vein compression: a reliable sign of internal hernia after gastric bypass

Internal obstructions secondary to internal hernia (IH) are frequent (i.e. 0-16%) and dreaded mid-term (postoperative 12-24 month) complications after Roux-Y-gastric bypass (RYGB) [1]. The absence of closure of the mesenteric defects [1] combined with few adhesions formation after laparoscopy [2] and rapid visceral fat loss [3] participate to IH. Clinical presentation is characterized by unspecific and intermittent gastro-intestinal symptoms, responsible for delayed diagnosis [1]. The CT-scan features vary from a combination of unspecific vascular and digestive signs (Figure 1 A) to evidence of bowel ischemia [4].

Source: Surgery for Obesity and Related Diseases - February 1, 2019 Category: Surgery Authors: L Genser, PA Colas, C Barrat Source Type: research