The orifice behind a gastroenterostomy has infrequently been the site of an internal hernia. During the past 75 years, the 175 published cases of a retroanastomotic hernia have shown a high mortality.
In the present description of three additional patients, whose conditions were successfully managed, two had chronic obstruction with efferent-loop herniation. The other patient developed an afferent-loop hernia that, because of prolonged observation, progressed to gangrene of the involved jejunum and duodenum, requiring extensive resection. Closure of the internal hernial ring at the time of the initial gastric operation prevents the formation of retroanastomotic hernia.