A Peterson's hernia and subsequent small bowel volvulus: surgical reconstruction utilizing transverse colon as a new Roux-en-Y limb - 1 case.
10.4174/jkss.2013.85.6.309
- Author:
Jae Seong JANG
;
Dong Gue SHIN
- Publication Type:Case Report
- Keywords:
Roux-en-Y;
Gastrectomy;
Hernia;
Volvulus
- MeSH:
Abdominal Pain;
Aged;
Anastomosis, Roux-en-Y;
Colon, Transverse*;
Extremities*;
Gastrectomy;
Gastric Bypass;
Gastric Stump;
Hernia*;
Humans;
Intestinal Volvulus*;
Intestines;
Jejunum;
Laparotomy;
Stomach Neoplasms
- From:Journal of the Korean Surgical Society
2013;85(6):309-313
- CountryRepublic of Korea
- Language:English
-
Abstract:
Peterson's hernia is an internal hernia that can occur after Roux-en-Y anastomosis. It often accompanies small bowel volvulus and is prone to strangulation. Reconstruction of intestinal continuity after massive small bowel resection in a patient who undergoes near total gastrectomy and Roux-en-Y anastomosis can be difficult. A 74-year-old man who had undergone a near total gastrectomy and Roux-en-Y gastrojejunostomy for stomach cancer presented with abdominal pain. The preoperative computed tomography showed strangulated small bowel volvulus. During the emergent laparotomy, we found a strangulated Peterson's hernia with small bowel volvulus. After resection of the necrotized intestine, we made a new Roux-en-Y anastomosis connecting the remnant stomach and the jejunum with a transverse colon segment. We were safely able to connect the remnant stomach and the jejunum by making a new Roux-en-Y anastomosis utilizing a transverse colon segment as a new Roux-limb by two stage operation.
