INTESTINAL OBSTRUCTION AND INTERNAL HERNIA THROUGH LAPAROSCOPIC GASTRIC BYPASS
Abstract
Abstract:
The postoperative intestinal obstruction syndrome is a known complication of bariatric surgery and has different etiologies: bridles, volvulus, stenosis or internal hernias. We present the clinical case of a 61-year-old patient who underwent gastric bypass retrocolic ringed and laparoscopic cholecystectomy due to obesity who suffers internal hernia through a mesenteric orifice with irreversible intestinal ischemia, which requires disassembly of the bypass with intestinal resection, including a food loop and foot. of the loop, partial gastrectomy and urgent splenectomy. We proceed to reconstruction of the transit with gastro-gastric end-lateral and latero-lateral jejunojejunal anastomosis. In patients undergoing laparoscopic bariatric surgery, it is important to consider intestinal obstruction due to internal hernia as a serious, relatively frequent and potentially fatal complication.
Resumen:
El síndrome de obstrucción intestinal postoperatoria es una complicación conocida de la cirugía bariátrica y tiene diferentes etiologías: bridas, vólvulos, estenosis o hernias internas. Presentamos el caso clínico de una paciente de 61 años intervenida de bypass gástrico retro cólico anillado y colecistectomía laparoscópicos por obesidad que sufre hernia interna a través de orificio mesentérico con isquemia intestinal irreversible que obliga a desmontaje del bypass con resección intestinal, incluyendo asa alimentaria y pie de asa, gastrectomía parcial y esplenectomía urgente. Se procede a reconstrucción del tránsito con anastomosis gastro-gástrica T-L y yeyunoyeyunal L-L. En pacientes intervenidos de cirugía bariátrica laparoscópica es importante tener en cuenta la obstrucción intestinal por hernia interna como complicación grave, relativamente frecuente y potencialmente mortal.
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