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SM ISO690:2012 GHIDIRIM, Carolina, BALAN, Sergiu. Internal hernia - late complication after Roux-en Y gastric bypass. In: Cercetarea în biomedicină și sănătate: calitate, excelență și performanță, Ed. 1, 20-22 octombrie 2021, Chişinău. Chișinău, Republica Moldova: 2021, p. 295. ISBN 978-9975-82-223-7 (PDF).. |
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Cercetarea în biomedicină și sănătate: calitate, excelență și performanță 2021 | ||||||
Conferința "Cercetarea în biomedicină și sănătate: calitate, excelență și performanță" 1, Chişinău, Moldova, 20-22 octombrie 2021 | ||||||
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Pag. 295-295 | ||||||
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Rezumat | ||||||
Background. Internal hernia is a late complication of bariatric surgery, which can lead to strangulation or perforation of the intestine. Roux-en Y gastric bypass (RYGB) is the most popular bariatric surgery, and increasing the number of surgeries increases it's incidence. Objective of the study. Evaluation of predictive clinical signs and establishment of a diagnostic and therapeutic algorithm for internal hernias after RYGB. Material and Methods. The study includes 11 (2%) cases from 535 patients undergoing RYGB during 2009-2021, who developed an internal hernia. The mean age was 37.9 ± 6.6 years, weight - 118.6 ± 26.3 kg, preoperative BMI - 41.4 ± 6.9 kg / m². Retrocolic-antegastric RYGB was performed in 378 (70.6%) cases, and antecholic-antegastric RYGB in 157 (29.4%) cases. Results. The period of installation of clinical signs was 22.6 ± 17.1 months with the predominance of pain, present in 11 (100%) cases, vomiting - 4 (36.4%) cases, absence of gas emission - 3 (27,3%) cases. The incidence of hernia predominated in the retrocholic variant of mounting the Roux loop - 10 (90.9%) cases. The types of hernia detected were: mesocolic defect hernia - 4 cases, mesenteric defect hernia - 5 cases and Petersen hernia - 2 cases. Imaging examination was suggestive of acute forms with obstructive syndrome, but inefficient in chronic evolution. In 4 cases, urgent intervention was performed, 3 of which were followed by small bowel resections. Conclusion. Internal hernia is a complication of Roux-en Y gastric bypass, which presents diagnostic difficultie due to the atypical evolution and uncertainty of the imaging examination. To prevent the fatal complications, revision of the abdominal cavity is the only option. |
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Cuvinte-cheie bariatric surgery, gastric bypass, internal hernia, chirurgia bariatrică, gastric bypass, hernie internă |
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