JOURNAL OF CLINICAL SURGERY ›› 2023, Vol. 31 ›› Issue (4): 357-359.doi: 10.3969/j.issn.1005-6483.2023.04.016

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Nine cases of Petersen’s hernia after gastrectomy and review of the literature

  

  1. Department of Gastrointestinal Colorectal and Anal Surgery,ChinaJapan Union Hospital of Jilin University,Jilin,Changchun 130033,China
  • Received:2022-06-22 Accepted:2022-06-22 Online:2023-04-25 Published:2023-04-25

Abstract: Objective   To summarize the etiology,clinical features,treatment and prevention of internal abdominal hernia after gastric surgery(Petersen hernia) and improve the understanding of Petersen hernia.  Methods   A retrospective analysis in January 2018 to December 2021 jilin university fellowship between China and Japan hospital for treatment of 9 cases after gastrectomy Petersen hernia patients,7 cases underwent open Bie-ⅱ anastomosis and 2 cases underwent Roux-en-Y anastomosis due to the primary disease.The median duration of onset was 2 days.The percentage of neutrophils in blood routine was increased to varying degrees.Preoperative abdominal CT showed anastomotic wall thickening,proximal small bowel obstruction sign 4 cases,small intestine torsion signs in 2 cases,no special signs only 3 cases of small intestinal obstruction,has not been in patients with preoperative diagnosis for Petersen hernia,all patients underwent surgical treatment,intraoperative see output section of the small intestine to shift into the Petersen clearance and hernia in 5 cases,There were 3 cases without torsional herniation into Petersen space in the output segment and 1 case with torsional herniation into Petersen space in the input segment.Among them,4 patients underwent intestinal resection and anastomosis due to intestinal necrosis.  Results   One patient developed pleural and abdominal effusion after operation,and all patients were cured and discharged after treatment.  Conclusions   Petersen’s hernia is a relatively rare complication after gastrectomy.Preoperative abdominal CT can help to determine the criticality of the patient’s condition and can be the first choice of examination.A small number of patients with acute pancreatitis should pay attention to preoperative and postoperative amylase changes,and once the diagnosis is confirmed,surgery should be performed as soon as possible.

Key words: gastrectomy, petersen hernia, intra-abdominal hernia

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