Laparoscopic closure of mesenteric defects after Roux-en-Y gastric bypass

Two case reports are presented of incarcerated small-bowel internal hernias through mesenteric defects following Roux-en-Y gastric bypass surgery (one case each of open and laparoscopic). Both patients first presented to phys icians unfamiliar with bariatric surgery complaining of vague, cramping mid abdominal pain, and the correct diagnosis was not revealed until laparoscop ic surgery was performed. Treatment then resulted in quick recoveries, This type of hernia can evade radiologic testing. Prompt clinical recognition a nd treatment is necessary to prevent small-bowel infarction.