Department of General and Visceral Surgery, General Hospital of Bregenz, Carl-Pedenz-Straße 2, 6900, Bregenz, Austria.
Department of Radiology, General Hospital of Bregenz, Bregenz, Austria.
Obes Surg. 2023 Aug;33(8):2620-2624. doi: 10.1007/s11695-023-06694-0. Epub 2023 Jul 4.
Unknown intestinal rotation anomaly poses a challenge in laparoscopic gastric bypass surgery. We present a case of a patient with intestinal non-rotation that stayed undetected throughout performing a laparoscopic Roux-en-Y gastric bypass. As a result, the alimentary limb was constructed in an anti-peristaltic way, and the whole gastric bypass was located far more distally than usual. Postoperatively, the patient presented with recurring nausea and vomiting. After several diagnostic steps, a computed tomography finally revealed the inadvertently reverse directed gastric bypass and the pre-existing condition of intestinal non-rotation. This was followed by a diagnostic laparoscopy and the reconstruction of the gastric bypass in "mirrored" technique.
未知的肠旋转异常给腹腔镜胃旁路手术带来了挑战。我们报告了一例肠旋转不良的病例，该病例在进行腹腔镜 Roux-en-Y 胃旁路手术时一直未被发现。结果，输入襻被构建成了逆蠕动方向，整个胃旁路的位置比通常情况下远得多。术后，患者出现反复恶心和呕吐。经过几次诊断步骤，计算机断层扫描最终揭示了意外的反向胃旁路和肠旋转不良的原有情况。随后进行了诊断性腹腔镜检查，并采用“镜像”技术重建了胃旁路。
