Abstract
We report a rare case of internal hernia after gastrectomy. A 64-year-old man, who had undergone total gastrectomy (Roux-en-Y reconstruction) for gastric cancer 9 months earlier, was admitted to our hospital ten days after the onset of abdominal pain and constipation. He had mild tenderness in the upper abdominal region, but no peritoneal irritation. Abdominal X-ray revealed intestinal gas only on the right side of the abdomen, and abdominal CT scan showed dilation of the right colon and the whirl sign. We diagnosed an internal hernia and performed surgery. The ileum was strangulated through the space between the mesentery of the Roux-limb and transverse mesocolon (Petersen's defect). We reversed the ileal strangulation and closed the hernia orifice.
