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ARTICLE |

Postgastrectomy Internal Hernia

ROBERT R. LARSEN, MD; NICHOLAS S. SALIBA, MD; KENNETH C. SAWYER, MD
Arch Surg. 1964;89(4):725-730. doi:10.1001/archsurg.1964.01320040141025.
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Any gastric operation resulting in gastrojejunostomy produces a potential internal hernia ring which may be lethal in the immediate or remote postoperative period. It is the purpose of this paper to report two nonfatal cases, to alert the clinician to this possibility, and to remind the surgeon that this ring may be easily and expeditiously eliminated at the time of the original operation.

Report of Cases  Case 1, a 75-year-old female, was admitted because of recurrent abdominal pain and distention with nausea and vomiting. Each episode lasted for a few hours and subsided spontaneously. One episode required hospitalization but subsided shortly after admission. The patient had a partial gastrectomy and posterior gastrojejunostomy two years previously for upper gastrointestinal hemorrhage.Physical examination revealed a moderately distended abdomen with visible peristalsis. There was generalized tympany. Bowel sounds were normal and there was an epigastric mass. Tenderness was primarily in the left upper

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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