Diagnosis and treatment of Roux and Y space hernia after Roux-en-Y gastric bypass surgery for gastric cancer patients: a clinical analysis of 12 cases / 中华全科医师杂志

ABSTRACT

Clinical data of 12 patients with gastric cancer,in whom the Roux and Y space hernia developed after gastrectomy with Roux-en-Y anastomosis in our hospital from June 2010 to December 2018,were retrospectively analyzed.The clinical symptoms of patients were abdominal pain,distension and ileus.The main CT findings were torsion of mesentery with whirlpool sign,intestinal obstruction and exudants around the small bowels.During the operation it was found that small bowels herniated into the Roux and Y space in all 12 patients,the necrotic small intestines were resected in 4 patients.Ten patients were recovered,and 2 died.No recurrence was observed in all 10 patients during 3 month-follow up.The postoperative Roux and Y space hernia is a internal hernia and difficult to be diagnosed.The CT scan is valuable for diagnosis of Roux and Y space hernia;the main CT signs were swirled appearance of mesentery and small bowel obstruction.Once diagnosis is made the emergency operation is necessary.