The Well-Rounded Mama

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One of the risks that tends to be de-emphasized to women considering Gastric Bypass (GB) surgery is the chance of internal hernia, especially one which occurs during pregnancy. What is an interior hernia? An interior hernia is defined as a protrusion of the intestine through a defect within the peritoneal cavity, instead of an external (or incisional) hernia that protrudes through all levels of the abdominal wall.

Internal hernias more often than not happen through iatrogenic problems created surgically. The results of developing an internal hernia can include Small Bowel Obstruction (SBO), lack of adequate blood circulation to the intestine, and causing necrotic tissue, gangrene, and a need for colon resection. In extreme cases, it can lead to death.

Granted, the risk for inner hernia is not a huge risk, although it’s difficult to pin down exactly what the risk really is. One research found a 3.1% incidence of internal hernia after GB in a series of 2000 patients, while a different study found a 4.5% rate in a series of 1000 patients. Because of the increasing range of this problem and its damaging effects potentially, surgeons should have a high scientific suspicion for inner hernia after LGBP. Of course, it is important to remember that most women who’ve a Gastric Bypass and then a pregnancy afterwards won’t experience an interior hernia.

However, there are a few women who create a hernia during being pregnant after Gastric Bypass, and it can be a very serious concern. Women and infants have died out of this complication (see case reports below). Therefore, it is critical to raise awareness about this possible risk. Any right time a pregnant woman with a history of Gastric Bypass encounters significant stomach pain, this must be studied very seriously.

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Physicians with experience both in WLS (Weight Loss Surgery), pregnancy, and intestinal issues should be consulted. Oftentimes, E.R. Or family practice doctors miss inner hernias, CT scans are not always definitive, and as a total result, there are a number of scary “near-miss” tales out there. Most government bodies concur that exploratory surgery is usually warranted, in case just, since skipped or postponed diagnosis is not unusual and can be deadly.

One of my concerns is whether or not this risk is properly told women before they have WLS. WLS is being actively promoted to fats women in an effort to make childbearing “safer,” yet are they really being informed enough concerning this possible problem of pregnancy after GB? And if they ahead choose to go, have the surgery, and then have a pregnancy, have they been sufficiently alerted to watch for abdominal pain and to seek help immediately if it occurs? On a more cynical be aware, isn’t it interesting these situations are being recounted as case reports in the medical books, but yet you hardly ever see them outlined in the studies on being pregnant after WLS?

Granted, this problem is not so routine you’d see a lot of instances of it, but for every full case report that is published, there are a number more that are not being written up probably. Why isn’t there more attention to this complication in the pregnancy-after-WLS literature? Note: Additional case reports can be found on Pubmed but weren’t right here because they did not come with an abstract designed for review.