Cecal volvulus as a rare complication of internal hernia after Roux-en-Y gastric bypass: a case report and literature review

J Surg Case Rep. 2024 Apr 24;2024(4):rjae252. doi: 10.1093/jscr/rjae252. eCollection 2024 Apr.

Abstract

This case report describes a rare instance of cecal volvulus resulting from an internal hernia through Petersen's space, occurring 20 years after Roux-en-Y gastric bypass surgery, marking it as the second such case in English literature. An 81-year-old female presented with symptoms of bowel obstruction, and imaging findings concerning for cecal volvulus. Emergency surgery revealed necrotic bowel due to an internal hernia, necessitating a right hemicolectomy, with subsequent successful anastomosis and hernia defect closure. The incidence of internal hernias post-gastric bypass is notable, emphasizing the critical need for surgical vigilance. This case underscores the importance of considering internal hernias in differential diagnoses for bowel obstruction in post-bariatric surgery patients, highlighting the life-saving role of prompt surgical intervention in the management of cecal volvulus complications.

Keywords: Petersen’s defect; Roux-en-Y gastric bypass; cecal volvulus; internal hernia.

Publication types

  • Case Reports