Management of High Output Enterocutaneous Fistula due to Richter's Hernia After Gastric Bypass: Video Demonstration

Abstract

Introduction: The increase in laparoscopic surgery in patients with obesity increases the incidence of trocar site hernia (TSH). Therefore, TSH represents a risk for the development of Richter's hernia (RH).

Methods: We present the unusual case of a postoperative gastric bypass patient complicated with a high output enterocutaneous fistula through a trocar site wound.

Results: The Laparoscopic surgery consists of an RH reduction, enterotomy, and repair of the preperitoneal space.

Conclusion: RH complicated by high-output enterocutaneous fistula has not been previously reported. It is essential to close the preperitoneal space in bariatric surgery to avoid these complications.

Keywords: Enterocutaneous fistula; Gastric bypass; Richter’s hernia; Trocar site hernia.