Internal herniation through Petersen's defect following Roux-en-Y gastric bypass presenting as subacute bilateral lower extremity edema due to IVC compression - a case report.
- 1Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, United States.
Abstract
A 38-year-old woman with a history of Roux-en-Y gastric bypass (RYGB) 2 years prior presented to the bariatric clinic on multiple occasions with postprandial abdominal pain and bloating and bilateral lower extremity edema. Abdominal pain did not improve despite antiacid medication and dietary recommendations. Computed tomography scan of the abdomen revealed an internal hernia (IH) through Petersen's defect (a potential space between the Roux limb and transverse colon), with a mass effect on the inferior vena cava by herniated bowel. Diagnostic laparoscopy confirmed the diagnosis. Reduction of the hernia and defect closure resulted in full symptom resolution. This case highlights the importance of high clinical suspicion for IH in any patient with a history of RYGB and abdominal pain, even when symptoms are chronic and/or atypical. Early recognition is important for prompt treatment and prevention of bowel ischemia and necrosis.
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BibTeX
@article{bryan2026internal,
title = {{Internal herniation through Petersen's defect following Roux-en-Y gastric bypass presenting as subacute bilateral lower extremity edema due to IVC compression - a case report.}},
author = {Reese Bryan and Stephanie Garcia and Zhamak Khorgami},
journal = {Journal of surgical case reports},
year = {2026},
month = oct,
doi = {10.1093/jscr/rjag937},
url = {https://europepmc.org/article/MED/42899224},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Internal herniation through Petersen's defect following Roux-en-Y gastric bypass presenting as subacute bilateral lower extremity edema due to IVC compression - a case report.
AU - Reese Bryan
AU - Stephanie Garcia
AU - Zhamak Khorgami
PY - 2026
DA - 2026/10/19
JO - Journal of surgical case reports
DO - 10.1093/jscr/rjag937
UR - https://europepmc.org/article/MED/42899224
AB - A 38-year-old woman with a history of Roux-en-Y gastric bypass (RYGB) 2 years prior presented to the bariatric clinic on multiple occasions with postprandial abdominal pain and bloating and bilateral lower extremity edema. Abdominal pain did not improve despite antiacid medication and dietary recommendations. Computed tomography scan of the abdomen revealed an internal hernia (IH) through Petersen's defect (a potential space between the Roux limb and transverse colon), with a mass effect on the inferior vena cava by herniated bowel. Diagnostic laparoscopy confirmed the diagnosis. Reduction of the hernia and defect closure resulted in full symptom resolution. This case highlights the importance of high clinical suspicion for IH in any patient with a history of RYGB and abdominal pain, even when symptoms are chronic and/or atypical. Early recognition is important for prompt treatment and prevention of bowel ischemia and necrosis.
SN - 2042-8812
ER -