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

## TL;DR

A rare case of cecal volvulus caused by an internal hernia 20 years after gastric bypass surgery is reported, emphasizing the need for prompt surgical intervention.

## Contribution

This is the second reported case of cecal volvulus due to an internal hernia after Roux-en-Y gastric bypass, adding to the limited literature on this rare complication.

## Key findings

- Cecal volvulus occurred 20 years after Roux-en-Y gastric bypass due to an internal hernia through Petersen’s space.
- Emergency surgery revealed necrotic bowel, requiring a right hemicolectomy and hernia defect closure.
- The case highlights the importance of considering internal hernias in post-bariatric surgery patients with bowel obstruction.

## 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.