CT findings in Petersen’s hernia as a complication of bariatric surgery with a Roux-en-Y gastric bypass

Abstract

Objectives: To describe tomographic findings in Petersen’s herniaassociated with laparoscopic Roux-en-Y gastric bypass surgery.Methods: Two radiologists, experts in abdominal radiology,independently and retrospectively reviewed four cases of Petersen’shernia confirmed surgically in three patients, between March 2007and July 2008, who had undergone laparoscopic Roux-en-Y gastricbypass surgery with an antecolic anastomosis for treating morbidobesity. The main imaging findings were the presence and locationof abdominal distention, the herniated intestinal loop segment, thepresence of mesenteric vessel rotation and haziness of mesentericfat, the position of the Treitz angle ligament and the course of theileum. Results: In all cases, abdominal distention was located inthe upper abdomen; the herniated jejunal loop was located abovethe gastric level; mesenteric vessel rotation was associated withmesenteric fat haziness; the middle/distal ileum descended from theleft hypochondrium; and the Treiz angle was displaced anteriorly andto the right. Both examiners fully agreed with the analysis of findings.Conclusions: The association of computed tomography findingsdescribed in patients with a history of bariatric surgery is a strongpredictor of Petersen’s hernia.

Keywords

• Hernia
• Tomography
• X-ray computed
• Gastroplasty/methods
• Postoperative complications