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Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report

BACKGROUND: The incidence of internal hernias has recently increased in concordance with the popularization of laparoscopic surgery. Of particular concern are internal hernias occurring in Petersen's space, a space that is surgically created after treatment for gastric cancer and obesity. These...

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Autores principales: Yasuda, Tomohiko, Sakurazawa, Nobuyuki, Kuge, Komei, Omori, Jun, Arai, Hiroki, Kakinuma, Daisuke, Watanabe, Masanori, Suzuki, Hideyuki, Iwakiri, Katsuhiko, Yoshida, Hiroshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727264/
https://www.ncbi.nlm.nih.gov/pubmed/35071535
http://dx.doi.org/10.12998/wjcc.v10.i1.323
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author Yasuda, Tomohiko
Sakurazawa, Nobuyuki
Kuge, Komei
Omori, Jun
Arai, Hiroki
Kakinuma, Daisuke
Watanabe, Masanori
Suzuki, Hideyuki
Iwakiri, Katsuhiko
Yoshida, Hiroshi
author_facet Yasuda, Tomohiko
Sakurazawa, Nobuyuki
Kuge, Komei
Omori, Jun
Arai, Hiroki
Kakinuma, Daisuke
Watanabe, Masanori
Suzuki, Hideyuki
Iwakiri, Katsuhiko
Yoshida, Hiroshi
author_sort Yasuda, Tomohiko
collection PubMed
description BACKGROUND: The incidence of internal hernias has recently increased in concordance with the popularization of laparoscopic surgery. Of particular concern are internal hernias occurring in Petersen's space, a space that is surgically created after treatment for gastric cancer and obesity. These hernias cause devastating sequelae, such as massive intestinal necrosis, fatal Roux limb necrosis, and superior mesenteric vein thrombus. In addition, protein-losing enteropathy (PLE) is a rare syndrome involving gastrointestinal protein loss, although its relationship with internal Petersen’s hernias remains unknown. CASE SUMMARY: A 75-year-old man with a history of laparotomy for early gastric cancer developed Petersen's hernia 1 year and 5 mo after surgery. He was successfully treated by reducing the incarcerated small intestine and closure of Petersen’s defect without resection of the small intestine. Approximately 3 mo after his surgery for Petersen’s hernia, he developed bilateral leg edema and hypoalbuminemia. He was diagnosed with PLE with an alpha-1 antitrypsin clearance of 733 mL/24 h. Double-balloon enteroscopy revealed extensive jejunal ulceration as the etiology, and it facilitated minimum bowel resection. Pathological analysis showed extensive jejunal ulceration and collagen hyperplasia with nonspecific inflammation of all layers without lymphangiectasia, lymphoma, or vascular abnormalities. His postoperative course was unremarkable, and his bilateral leg edema and hypoalbuminemia improved after 1 mo. There was no relapse over the 5-year follow-up period. CONCLUSION: PLE and extensive jejunal ulceration may occur after Petersen's hernia. Double-balloon enteroscopy helps identify and resect these lesions.
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spelling pubmed-87272642022-01-21 Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report Yasuda, Tomohiko Sakurazawa, Nobuyuki Kuge, Komei Omori, Jun Arai, Hiroki Kakinuma, Daisuke Watanabe, Masanori Suzuki, Hideyuki Iwakiri, Katsuhiko Yoshida, Hiroshi World J Clin Cases Case Report BACKGROUND: The incidence of internal hernias has recently increased in concordance with the popularization of laparoscopic surgery. Of particular concern are internal hernias occurring in Petersen's space, a space that is surgically created after treatment for gastric cancer and obesity. These hernias cause devastating sequelae, such as massive intestinal necrosis, fatal Roux limb necrosis, and superior mesenteric vein thrombus. In addition, protein-losing enteropathy (PLE) is a rare syndrome involving gastrointestinal protein loss, although its relationship with internal Petersen’s hernias remains unknown. CASE SUMMARY: A 75-year-old man with a history of laparotomy for early gastric cancer developed Petersen's hernia 1 year and 5 mo after surgery. He was successfully treated by reducing the incarcerated small intestine and closure of Petersen’s defect without resection of the small intestine. Approximately 3 mo after his surgery for Petersen’s hernia, he developed bilateral leg edema and hypoalbuminemia. He was diagnosed with PLE with an alpha-1 antitrypsin clearance of 733 mL/24 h. Double-balloon enteroscopy revealed extensive jejunal ulceration as the etiology, and it facilitated minimum bowel resection. Pathological analysis showed extensive jejunal ulceration and collagen hyperplasia with nonspecific inflammation of all layers without lymphangiectasia, lymphoma, or vascular abnormalities. His postoperative course was unremarkable, and his bilateral leg edema and hypoalbuminemia improved after 1 mo. There was no relapse over the 5-year follow-up period. CONCLUSION: PLE and extensive jejunal ulceration may occur after Petersen's hernia. Double-balloon enteroscopy helps identify and resect these lesions. Baishideng Publishing Group Inc 2022-01-07 2022-01-07 /pmc/articles/PMC8727264/ /pubmed/35071535 http://dx.doi.org/10.12998/wjcc.v10.i1.323 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Yasuda, Tomohiko
Sakurazawa, Nobuyuki
Kuge, Komei
Omori, Jun
Arai, Hiroki
Kakinuma, Daisuke
Watanabe, Masanori
Suzuki, Hideyuki
Iwakiri, Katsuhiko
Yoshida, Hiroshi
Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report
title Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report
title_full Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report
title_fullStr Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report
title_full_unstemmed Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report
title_short Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report
title_sort protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in petersen's space: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727264/
https://www.ncbi.nlm.nih.gov/pubmed/35071535
http://dx.doi.org/10.12998/wjcc.v10.i1.323
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