Internal hernia after laparoscopic-assisted proximal gastrectomy with jejunal interposition for gastric cancer: a case report

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• 作者：Kotaro Hirashima ; Takashi Ishikawa ; Shin-ichi Kosugi ; Yosuke Kano…
• 关键词：Internal hernia ; Laparoscopic ; assisted proximal gastrectomy ; Jejunal interposition
• 刊名：Surgical Case Reports
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：1
• 期：1
• 全文大小：1358KB
• 参考文献：1.Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N. Japanese laparoscopic surgery study group. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68鈥?2.PubMed Central PubMed CrossRef
  2.Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report鈥揳 phase III multicenter, prospective, randomized trial (KLASS Trial). Ann Surg. 2010;251:417鈥?0.PubMed CrossRef
  3.Guzman EA, Pigazzi A, Lee B, Soriano PA, Nelson RA, Benjamin Paz I, et al. Totally laparoscopic gastric resection with extended lymphadenectomy for gastric adenocarcinoma. Ann Surg Oncol. 2009;16:2218鈥?3.PubMed CrossRef
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  12.Kojima K, Inokuchi M, Kato K, Motoyama K, Sugihara K. Petersen's hernia after laparoscopic distal gastrectomy with Roux-en-Y reconstruction for gastric cancer. Gastric Cancer. 2014;17:146鈥?1.PubMed CrossRef
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• 作者单位：Kotaro Hirashima (1)
  Takashi Ishikawa (1)
  Shin-ichi Kosugi (1)
  Yosuke Kano (1)
  Yu Sato (1)
  Hiroshi Ichikawa (1)
  Takaaki Hanyu (1)
  Takeo Bamba (1)
  Toshifumi Wakai (1)
  
  1. Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chu-o-ku, Niigata, 951-8510, Japan
  
• 刊物类别：Surgery;
• 刊物主题：Surgery;
• 出版者：Springer Berlin Heidelberg
• ISSN：2198-7793

文摘

Internal hernia after gastrectomy is a rare complication. It can progress rapidly to vascular disturbance, necrosis, and perforation, therefore early diagnosis and surgical treatment is essential. We present a case of internal hernia following laparoscopic-assisted proximal gastrectomy with jejunal interposition reconstruction in a 68-year-old man, who presented with acute abdominal pain and vomiting. Computed tomography showed a whirl sign, ascites, and a closed-loop formation of the small intestine. We diagnosed an internal hernia and performed emergency surgery. Laparotomy revealed chyle-like ascites and extensive small intestine with poor color. We recognized that about 20 cm of jejunum from the ligament of Treitz was strangulated behind the pedicle of the jejunum lifted during laparoscopic-assisted proximal gastrectomy. We relieved the strangulation, whereupon the color of the strangulated intestine was restored. Therefore, we did not perform intestinal resection and reconstruction. Finally, we fixed the jejunal pedicle and mesentery of the transverse colon. We report this case as there are few reported cases of internal hernia after laparoscopic-assisted proximal gastrectomy. Keywords Internal hernia Laparoscopic-assisted proximal gastrectomy Jejunal interposition