Petersen’s Hernia after Laparoscopic Roux-en-Y Gastric Bypass Presenting in Second Trimester Pregnancy - Abstract
As more women of childbearing age undergo bariatric surgery to treat the
growing epidemic of obesity, surgeons are being faced with the difficult dilemma
of pregnant post-bariatric patients with abdominal pain. Development of an internal
hernia is a rare but serious complication of roux-en-y gastric bypass that requires
emergent surgery to prevent bowel necrosis. It is imperative to maintain a high clinical
suspicion for this potentially lethal surgical emergency to avoid any delay in imaging
and operative intervention. In the following case report, we review two patients who
presented in the second trimester of pregnancy with internal hernias. We discuss the
case of a 27-year-old female in her 26th week of pregnancy and a 35-year-old
female in her 25th week of pregnancy presenting with abdominal pain and vomiting
with a history of roux-en-y gastric bypass. Both patients underwent abdominal imaging
that raised concern for internal hernias. The patients had successful outcomes after
open and laparoscopic operative exploration with reduction and repair of Petersen’s
hernias.