THOÁT VỊ NỘI SAU MỔ CẮT ĐOẠN DẠ DÀY: BÁO CÁO 2 TRƯỜNG HỢP VÀ TỔNG QUAN Y VĂN

Abstract

Objective Internal hernia following gastrectomy is an uncommon disease. Preoperative diagnosis is difficult because clinical symptoms are nonspecific. However, it is a surgical emergency, accurate preoperative diagnosis is crucial for appropriate management. Multidetector computed tomography (CT) plays an essential role in preoperative diagnosis of internal hernias.

Methods Describing 2 cases, at Thong Nhat Hospital, Ho Chi Minh City. All patients went preoperative CT and proved surgically internal hernias: Peterson hernia, J-J hernia.

Results The combination of mesenteric swirl sign and small bowel obstructioon has the highest sensitivity and accuracy for internal hernia following gastrectomy. “Sandwich sign” an interposed small bowel between transverse colon and gastrojejunostomy’s limb can be a predictor of Peterson hernia. Meanwhile, the positon of hernia orifice, which is close to the position of J-J anastomosis and the displacement of J-J anastomosis out of the left-mid abdomen can predict J-J hernia.

Conclusions Multidetector computed tomography (CT) plays an essential role in preoperative diagnosis of internal hernias following gastrectomy