Internal hernias and gastric perforation after a laparoscopic gastric bypass

A 27-year-old woman underwent laparoscopic Roux-en-Y gastric bypass. A retr ocolic-retrogastric herniation of most of the small bower and later a gastr ic perforation due to internal hernia at the mesenteric defect of the jejun o-jejunostomy occurred. These unusual, but not rare, complications are dire ctly related to the neoanatomy that follows gastric bypass and can lead to rapidly progressing and life-threatening situations. Proper evaluation of c linical signs and symptoms, early abdominal CT scan, and urgent operative i ntervention are mandatory to achieve a successful outcome.