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CASE REPORT
Dual incarcerated internal hernias after laparoscopic total gastrectomy with Roux-en-Y reconstruction for gastric cancer
  1. Zi Qin Ng,
  2. Willy Low,
  3. Pradeep Subramanian,
  4. Joel Stein
  1. Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
  1. Correspondence to Dr Zi Qin Ng, kentng{at}hotmail.co.uk

Summary

Internal hernia postgastrectomy is an exceedingly rare complication especially in the laparoscopic cohort of patients. Different types of internal hernias have been described, of which, Petersen's and jejunojejunostomy mesenteric defect hernias are the most commonly encountered followed by oesophageal defect and transverse colon mesocolic defect hernias. As the early presentation is always non-specific, late diagnosis of internal hernia has significant implication on morbidity and mortality. Here, we present a rare case of a patient with previous laparoscopy-assisted total gastrectomy presented with features of impending bowel obstruction and bowel ischaemia secondary to dual incarcerated internal hernias. We also reviewed the literature focusing on clinical features of internal hernia, essential CT findings and preventive measures.

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Footnotes

  • Contributors ZQN designed the study, collected and analysed the data, drafted the article and approved the final version of the article to be published. WL and PS analysed the data, revised the article and approved the final version of the article to be published. JS co-designed the study, analysed the data, critically reviewed the article, supervised the study and approved the final version of the article to be published.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.