2023 Volume 48 Issue 2 Pages 117-121
A 67-year-old male patient who had undergone open distal gastrectomy with D2 lymph node dissection and retrocolic Roux-en-Y reconstruction for antral gastric cancer 14 years ago, and had completed 5-years’ follow-up without recurrence was admitted to our hospital with fever, vomiting and abdominal distension. Computed tomography revealed a dilated Roux-limb and a closed loop on its left side dorsally; based on the findings, we made the diagnosis of internal hernia. Emergency surgery was performed, and intraoperatively, we identified herniation and incarceration, but no necrosis of the Roux-limb through the jejunojejunal mesenteric defect. We reduced the loop and closed the defect with a continuous non-absorbable suture. The postoperative course was uneventful and the patient was discharged on postoperative day 8. Although internal hernias are rare, closure of the jejunojejunal defect, as well as Petersen’s defect, with a continuous non-absorbable suture seems to be imperative for patients undergoing Roux-en-Y reconstruction.
