Diagnosis and treatment of Petersen hernia after gastrectomy: report of 6 cases
10.3760/cma.j.cn113855-20200218-00096
- VernacularTitle:胃癌术后Petersen疝六例诊治分析
- Author:
Jian CAO
1
;
Yingjiang YE
;
Masanori TERASHIMA
Author Information
1. 北京大学人民医院胃肠外科 100044
- From:
Chinese Journal of General Surgery
2020;35(11):870-873
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics, diagnosis and treatment of Petersen hernia after gastrectomy.Methods:The clinical data of 6 patients with Petersen hernia developed after gastrectomy in Shizuoka Cancer Center from Jan 2014 to Dec 2019 were retrospectively analyzed.Results:All 6 patients were males, with a median age of 76 years. The operative procedures for preceding gastrectomies were robotic-assisted total gastrectomy in 2 patients, laparoscopic distal gastrectomy in 2 patients, and laparoscopic proximal gastrectomy in 2 patients. Petersen′s defect was closed in all patients at previous gastrectomy. The time of onset was 1 month to 55 months after surgery. The main manifestations are acute pain in upper abdomen with nausea and vomiting. In all the cases, abdominal CT showed obstruction caused dilatation of the small intestine. The whirl sign was present in 3 patients. All the patients underwent reoperation with reduction and repair of the hernia. All the patients did not show obvious bowel necrosis. Their postoperative courses were uneventful, and all the patients were discharged. During the follow-up period, none of the patients developed complications related to the Petersen hernia.Conclusions:Petersen hernia is a rare complication of gastrectomy. It is important to conduct abdominal CT scanning as early as possible from the clinical history and physical findings, and to determine the surgical indication.
