Abstract
After undergoing laparoscopy-assisted total gastrectomy with retrocolic Roux-en-Y reconstruction for early gastric cancer, a 73-year-old man developed abdominal pain. The patient was diagnosed as having superior mesenteric vein thrombosis (SMVT) on enhanced abdominal computed tomography (CT). No signs of peritonitis were noted on the physical examination, and no evidence of bowel infarction was seen on enhanced CT. Therefore, conservative interventional radiology therapy with infusion of urokinase into the SMA was undertaken. However, during the initial stage of interventional radiology therapy, it was noted that the small intestine had migrated through Petersen's space, resulting in a strangulated bowel and mesenteric vessel twisting (whirl sign). Based on these findings, a Petersen's hernia was diagnosed, and surgery was performed after the interventional radiology therapy was completed. The small intestine was removed from Petersen's defect and repositioned. A second course of interventional radiology therapy with urokinase infusion into the SMA was then given. A rare case of internal hernia following gastrectomy with SMVT is reported.
