{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T07:28:29Z","timestamp":1793777309111,"version":"4.6.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A 38-year-old woman with a history of Roux-en-Y gastric bypass (RYGB) 2\u00a0years prior presented to the bariatric clinic on multiple occasions with postprandial abdominal pain and bloating and bilateral lower extremity edema. Abdominal pain did not improve despite antiacid medication and dietary recommendations. Computed tomography scan of the abdomen revealed an internal hernia (IH) through Petersen\u2019s defect (a potential space between the Roux limb and transverse colon), with a mass effect on the inferior vena cava by herniated bowel. Diagnostic laparoscopy confirmed the diagnosis. Reduction of the hernia and defect closure resulted in full symptom resolution. This case highlights the importance of high clinical suspicion for IH in any patient with a history of RYGB and abdominal pain, even when symptoms are chronic and\/or atypical. Early recognition is important for prompt treatment and prevention of bowel ischemia and necrosis.<\/jats:p>","DOI":"10.1093\/jscr\/rjag937","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:18:57Z","timestamp":1792433937000},"source":"Crossref","is-referenced-by-count":0,"title":["Internal herniation through Petersen\u2019s defect following Roux-en-Y gastric bypass presenting as subacute bilateral lower extremity edema due to IVC compression \u2013 a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5857-5052","authenticated-orcid":false,"given":"Reese","family":"Bryan","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Oklahoma School of Community Medicine , Tulsa, OK 74135 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Oklahoma School of Community Medicine , Tulsa, OK 74135 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhamak","family":"Khorgami","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Oklahoma School of Community Medicine , Tulsa, OK 74135 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"2026110401423267600_ref1","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1007\/s11695-018-3593-1","article-title":"Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the fourth IFSO global registry report 2018","volume":"29","author":"Welbourn","year":"2019","journal-title":"Obes Surg"},{"key":"2026110401423267600_ref2","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1007\/s11695-018-3472-9","article-title":"Internal hernia after laparoscopic gastric bypass: effect of closure of the Petersen defect - single-center study","volume":"29","author":"Blockhuys","year":"2019","journal-title":"Obes Surg"},{"key":"2026110401423267600_ref3","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1007\/s11695-007-9260-6","article-title":"Trends in internal hernia incidence after laparoscopic Roux-en-Y gastric bypass","volume":"17","author":"Ahmed","year":"2007","journal-title":"Obes Surg"},{"key":"2026110401423267600_ref4","doi-asserted-by":"publisher","first-page":"12847","DOI":"10.1038\/s41598-019-48241-x","article-title":"Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images","volume":"9","author":"Dou","year":"2019","journal-title":"Sci Rep"},{"key":"2026110401423267600_ref5","doi-asserted-by":"publisher","first-page":"311","DOI":"10.4293\/108680812X13427982376581","article-title":"Gastric bypass and abdominal pain: think of Petersen hernia","volume":"16","author":"Bakker","year":"2012","journal-title":"JSLS : J Soc Laparoendoscopic Surg"},{"key":"2026110401423267600_ref6","doi-asserted-by":"publisher","first-page":"1831","DOI":"10.1007\/s00423-021-02180-2","article-title":"Does the non-absorbable suture closure of the jejunal mesenteric defect reduce the incidence and severity of internal hernias after laparoscopic Roux-en-Y gastric bypass?","volume":"406","author":"Schneider","year":"2021","journal-title":"Langenbecks Arch Surg"},{"key":"2026110401423267600_ref7","doi-asserted-by":"publisher","first-page":"1648","DOI":"10.1002\/oby.21506","article-title":"Vena cava compression syndrome in patients with obesity presenting with edema and thrombosis","volume":"24","author":"Linicus","year":"2016","journal-title":"Obesity (Silver Spring)"},{"key":"2026110401423267600_ref8","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.soard.2025.11.019","article-title":"Diagnosis and treatment options for chronic abdominal pain after Roux-en-Y gastric bypass","volume":"22","author":"Committee","year":"2026","journal-title":"Surg Obes Relat Dis"},{"key":"2026110401423267600_ref9","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1016\/j.amjsurg.2004.08.049","article-title":"Internal hernias after laparoscopic Roux-en-Y gastric bypass","volume":"188","author":"Garza","year":"2004","journal-title":"Am J Surg"},{"key":"2026110401423267600_ref10","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1016\/S0025-6196(12)61125-2","article-title":"Pancreatic pseudocyst that compressed the inferior vena cava and resulted in edema of the lower extremities","volume":"67","author":"Browman","year":"1992","journal-title":"Mayo Clin Proc"},{"key":"2026110401423267600_ref11","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.crad.2008.10.008","article-title":"Sensitivity and specificity of eight CT signs in the preoperative diagnosis of internal mesenteric hernia following Roux-en-Y gastric bypass surgery","volume":"64","author":"Iannuccilli","year":"2009","journal-title":"Clin Radiol"},{"key":"2026110401423267600_ref12","doi-asserted-by":"publisher","first-page":"2754","DOI":"10.1007\/s11695-024-07316-z","article-title":"Double internal hernia: laparoscopic resolution","volume":"34","author":"Corvatta","year":"2024","journal-title":"Obes Surg"},{"key":"2026110401423267600_ref13","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1016\/j.soard.2023.03.019","article-title":"American Society for Metabolic and Bariatric Surgery literature review on prevention, diagnosis, and management of internal hernias after Roux-en-Y gastric bypass","volume":"19","author":"Altieri","year":"2023","journal-title":"Surg Obes Relat Dis"},{"key":"2026110401423267600_ref14","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1007\/s11695-022-06420-2","article-title":"Establishing methods of defect closure in Roux-en-Y gastric bypass: an international survey","volume":"33","author":"Mohammadi-Zaniani","year":"2023","journal-title":"Obes Surg"},{"key":"2026110401423267600_ref15","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1001\/jamasurg.2023.1042","article-title":"Long-term safety and efficacy of closure of mesenteric defects in laparoscopic gastric bypass surgery: a randomized clinical trial","volume":"158","author":"Stenberg","year":"2023","journal-title":"JAMA Surg"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/10\/rjag937\/72115785\/rjag937.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/10\/rjag937\/72115785\/rjag937.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T06:42:41Z","timestamp":1793774561000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag937\/8943662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,3]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag937","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,10]]},"article-number":"rjag937"}}