Internal hernias in pregnant females with Roux-en-Y gastric bypass: a systematic review

Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery
Devangi M DaveAlan A Saber

Abstract

Improved fertility following a Roux-en-Y gastric bypass (RYGB) can lead to pregnancy and increase the risk of internal herniation. A developing fetus and symptoms of pregnancy can mask the diagnosis and delay intervention, leading to deleterious maternal and fetal consequences. The aim of this systematic review is to summarize the literature regarding internal hernias during pregnancy, their management, and patient outcomes. A comprehensive literature search was undertaken on PubMed and Google Scholar to identify cases of internal hernias presenting during pregnancy after RYGB. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used for eligibility and inclusion of articles. Twenty-seven articles, with a total of 59 patients, regarding internal herniation during pregnancy after RYGB were identified. Epigastric pain and nausea and vomiting was the most common presentation. Regardless of orientation of the Roux limb and despite previous closure of mesenteric defects, internal herniation can still occur. A triad of epigastric pain, pregnancy, and a history of RYGB should be a red flag for clinicians to consider internal hernias as a top differential diagnosis. Prompt bariatric consultation and rapid...Continue Reading

Citations

Jul 6, 2020·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Siyu YangShi Wu Wen
Dec 11, 2020·BMJ Case Reports·Daniëlle Susan BonouvrieWouter K G Leclercq
Apr 17, 2021·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Mauricio Gonzalez-UrquijoJavier Rojas-Mendez
Jul 24, 2021·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Siyu YangRi-Hua Xie

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