Anyone else have an *internal* hernia repair? (Petersen's hernia, transmesenteric hernia,...

I am recovering from a football size internal hernia. About 3 weeks ago I had the worse pain in my upper abdomen area. I couldn't eat or sleep for 2 days. I thought I had food poisoning.  I had gastric bypass surgery 13 years ago. I'm I have never thrown up in my life but I had dry heaves with the pain I had. After visiting urgent care,they sent me to ER who sent me to my surgeons hospital for admission. 

Up until this point I know I had problems because going to the bathroom had become problematic. I felt like I had to painful knots in my stomach when I neared down but the Dr could never see it. I was on a low calorie diet and I believe it contributed to exasperatING my internal hernia due to major constipation.

The Dr said that my obstruction didn't cause damage to my intestine and she was glad I came in early to avoid losing my intestine.  

I am 3 weeks out from surgery. I am losing 1 to 2 lbs a day. I dump more easily and I can't eat hardly anything. My pain is getting better from incision but going to the bathroom is still painfull. When will I resume my normal diet? How long did it take for you to recover? 

I also had an intersussesion looping bowl fixed last year.

 

Kathy jo

 

While I know that this is an old message, I feel like it is full of great information, and I decided to add my story (I'm long winded so I apologize in advance) --- because I think that there are some lessons in my situation, and I really think that knowing stories like mine and those of the others who have posted to this thread might result in anything from saving a life at the most extreme, to the simpler (but truly significant) difference between a minor laproscopic repair and a major open surgery repair. 

 

My story -- which will include some perhaps unfounded medical conclusions along the way -- we'll never know the complete story. 

In 2008 I had a Distal RNY. I took a long time to get to goal, but got there, only to find that my goal was not a realistic number for me. In the end I settled at about 185 pounds as the right size for me. The weight that was healthy, didn't take effort to maintain, and which I could maintain through the complication of Reactive Hypoglycemia & dumping syndrome. My weight jumped a bit after having my tailbone out (another complication of losing all that weight), and after the tailbone surgery in 2011, I was on pain meds and my weight crept up a bit and I was pretty sure I'd seen the end of "onederland" but I was pretty stable weight wise, so I wasn't unduly worried. 

Then I began to have a series of Emergency Room visits. It is my belief that an exploratory surgery might have diagnosed and done a good job of eliminating internal hernia issues... but we'll never know. I am never keen to see a doctor. I had become "estranged" from my surgeon, mostly because they neglected to bill my insurance until after the time limit for submitting claims, so wanted me to pay for the surgery due to their oversight (hospital, anaesthesiologist, everyone else billed insurance and was paid).... and he was also a 50 mile drive and a 6 hour wait for an appointment was not unheard of. So i stopped seeing him. I believe it was my a major error on my part to not go see my bariatric surgeon when I began having issues with my gastrointestinal tract. So first piece of advice.... If you have had WLS don't forget the best person to see for GI problems is the wizard *****configured your GI tract. But I didn't. I ended up going to the local ER and being diagnosed with constipation. A cleanse, followed by a higher fiber diet, and a few modifications of my lifestyle, and I was good. 

Until it happened again, again diagnosed with constipation (even though I was pretty sure it was more nefarious than that).... likely I was having issues with internal hernias and blockages, but unfortunately about 1 out of 4 people WITH an internal hernia will not be diagnosed in any way other than through exploratory surgery.... it's hard to diagnose, sometimes impossible, with just scans. 

After this, any time I had abdominal pains, I would do everything I could to deal with constipation as the problem, and skipped the ER (even though I had ER level pain). It got to where I would take an extra pain pill, curl up in a ball on the floor, and just ride out the pain. 

Then came the day i had a stressful confrontation with my boss at work, and when I got home my stomach hurt. And the pain got so bad my husband called an ambulance, and i screamed for the entire ride to the hospital because laying flat caused me "the worst pain I've ever felt" 

Now I'm convinced heavily that I this time I had a Petersen's Hernia issue, because of the similarity with the pain I had when I was finally diagnosed with it a couple years later. But that was sort of the visit that came closest to killing me. When we got to the hospital, I was told harshly to stop screaming and a nurse came to me and scratched at my arm to get my attention and tell me to stop yelling because I was scaring other people. (I was scared too!). i was then given some pain meds, after an excruciating IV that I recall as more torture than the 9 attempts to start an IV before my RNY surgery. I was told to my face that I was just a drug seeker (remember, I am on a pain contract - and thus had access to pain meds and was not at the hospital to stop the pain.... no matter how bad the pain was, my primary purpose while there was for them to find the SOURCE of the pain and eliminate the problem).. I don't recall if they did a CAT scan or anything, but my memory was that they basically gave me fentanyl to stop the pain, told me to take tylenol, and contact my doctor if I continued to have pain. I didn't want to ever go back to the emergency room again if I was going to be labeled a drug seeker and my concerns ignored. 

In the summer of 2015 I had no health insurance as I had moved to a new state and had a new job where my health insurance would not begin until the fall, and I had the same stomach pain. I took a couple of extra pain pills and curled up in a ball on the bedroom floor -- somehow the floor was more comfortable than the bed) and I prayed. Over a week I had two or three days of this and then it passed. Anatomically I know that the way I was lying on the floor was most likely encouraging my bowels to exit the opening that was trapping them. 

Pretty much from 2014, with that disastrous ER visit, onward I had on-and-off abdominal pain. I didn't neglect my many constipation-defeating efforts, GAS-x was my friend, and an increasing stubbornness about seeing a doctor and being labeled a drug seeker. 

So fast forward to early summer 2016. I now have a good health insurance plan, but live in an area with very poor health care options (I had no idea how lucky I was when I lived in Phoenix, but where I live now, it's typical to have to drive 60 or more miles over mountain ranges to see specialists.)... and I'd gotten it in my head that the doctors would either tell me it was constipation or that I was a drug-seeker. Eating started to be uncomfortable so in June I stopped wanting to eat. Diet Mountain Dew became my major source of nutrition. I did eat, of course, but I also started to lose weight. by mid-july I'd lost 20 pounds. (in 6 weeks) and I continued to lose weight as food and I became "frenemies" ... my husband made sure I ate because it always alarms him when I just stop eating... but food just wasn't sitting well. It was not unusual for me to have abdominal discomfort, even pain, quite frequently. 

As the year went by, and the school year began (I'm a teacher) I ate slightly more frequently (belvita crackers for lunch, no breakfast, a tiny dinner) and the pain was more frequent and the weight fell off. Then we get to Monday October 10th... by then I'd lost 40 pounds and was only 5 pounds away from my target weight again (without effort) and the pain was more pronounced. I continued to ignore it. Tuesday the 11th, same thing. Wednesday, same thing. But when I got home from work on the 12th the pain was much worse. I thought I could ride it out, just as I'd done before. But the pain kept going up. Finally I asked my husband to help me to our room, where I was going to curl up on the bed (sleep for the night).... he asked if we should go to the ER but I nixed the idea, and lay down... when the pain went from bad back to the pain I had the last time I went to the ER.... the worst pain I had ever had in my life. My whole abdomen hurt to be poked and prodded, so I told hubby he was taking me to the ER. He suggested an ambulance, but I told him that they would make me lie down and the pain would be intolerable, so he drove me the 30 minutes to the nearest hospital. 

I was screaming by the time we were half way to the hospital, and they quickly put me in a room with a door (so as to not scare other patients).... it was too painful to talk even... just breathing hurt. hubby explained my pain for me, and I found enough fortitude to express my concern that it could be a Petersen's Hernia. 

They did juice me up pretty well so that I stopped screaming, though I couldn't lie down without the pain coming back three-fold. They did a CAT scan and the doc finally reappeared and told me all the things that were good with me, but then said that the CAT scan showed a Petersen's Hernia --- because there are no Bariatric Surgeons within 50 miles (I live in Klamath Falls Oregon), he would have to find a Bariatric Surgeon elsewhere who could operate on me, and I would have to be life-flighted and have emergency surgery. I asked the ER doc if my gut was in imminent danger of losing blood supply and dying and he said that it wasn't imminent, that I would be fine if I was operated on within 12 hours or so. 

About six hours later I was 200 miles away meeting with a bariatric surgeon. He was not nearly as optimistic about the state of my intestines and warned me that there was no guarantee about my outcome from surgery. He then ordered the team to not worry about any pre-op testing because he stated that there was nothing that would make him NOT operate, as operating was clearly the only thing that MIGHT save my life. I was terrified-- and all alone since I had ordered my husband to go home and get some sleep before driving the 4 hours to the hospital. 

I saw my surgeon yesterday for my follow up appointment, and I learned a lot more about the state of my guts when he took over my care. Normally a hernia is a small bit of intestine poking through a hole in the intestinal wall or interior structures.... in my case 80% of my small intestine had passed through a tiny hole in the "Petersen's Space" near the Y juncture and the transverse colon. While the surgeon tried to correct the problem laproscopically, he couldn't do it, and had to open me up with about a 3 in*****ision north of my belly button. he told me that my intestines, normally about the width of one of his fingers, were about four times their normal diameter and dripping with some disgusting (my words) stuff called Chyle (google it if you have a strong stomach). He had to open up the defect in the Petersen's space to get all my intestines out of where they did not belong and get them where they did belong. Then he stitched up the space to hopefully keep the intestines from returning to a place they didn't belong. Aside from being badly swollen, and having to examine every square inch of them looking for parts that might have perforated or died, I was lucky that they were intact and alive. He also repaired a small umbilical hernia that doctors had known about but didn't think mattered that much, but he took care of that at the same time. He told me that if my intestines had lost their blood supply and died, I would have also been unable to survive if I lost 80% of my intestines). He said that he operated just in time.

I learned when I visited with the surgeon that he usually doesn't use surgical staples, but he had used them on me because he considered that I had a very high probability of a wound infection, so he used staples to enable them to open me back up in a hurry. 

I will now sign on with him as the bariatric surgeon to go to if/when I ever have any more concerns. Yes, he's 200 miles away, but he still might be one of the closest surgeons within my insurance network. 

In reading some of the other posts on this thread, I think I'm lucky. I ended up being in the hospital for only a few days. I had no trouble moving to a liquid diet on day two, a soft diet on day 3, and a limited but normal diet by day 4. I still don't like eating, and am now down to my goal weight. (Ideal weight, more specifically, 185). 

So if YOU have unexplained abdominal pain after WLS.... see your weight loss surgeon. Don't ignore it. don't just curl up in a ball on the floor and hope it will go away. Just in case the super-close call isn't enough to convince you.... the bill for the Life-flight along (before insurance) is $57,000+ not including the cost of the two ambulance rides to and from airports, as well as the hospitalization and surgery and two separate ER visits. My part probably won't be any more than $20,000 .... but I'm a teacher living with a retired teacher husband the sole breadwinner.... it's a financial catastrophe on top of a medical one. The only bright side.... I'll only take 12 days off work (using up all my sick leave) and return to work on Halloween. 

 

Thanks for reading. 

Dear Lord what a journey you have had!! I'm so glad you are on the mend!!

I am going in for surgery tomorrow b3cause he thinks this is what's wrong. Up until now everyone has said I'm fine. All tests came back fine, but I'm anything but fine. I want yo thank you for posting this because my family doc (who is new) said I was just depressed and said it was all in my head. I know this was posted LONG ago, if you're still active here, or see this somehow, can you tell me how you're doing now?

Thank you for the quick reply. I believe my problem is in the small bowel as well.  The lower bowel responds to enemas, but I feel after I eat things are not travelling down.  I am getting concerned.  I do not drive and spend a lot of time alone.  I was alone the other night when I had to get to ER. 

I am surprised you are still experiencing issues.  I would have thought the hernia repair and exploratory would have remedied everything.  Do you or have you read anything that would give you any idea what may still be wrong?

I want to know how things turn out at your visit.  Our situations are similar.

PLEASE go get it checked!!! I am also recovering from this same Petersen's hernia. 1 week ago, I had the same pains that you are describing but they were sooooo bad I was out of my mind!

Thankfully my surgeon recognized it for what it was & I was rushed in for emergency surgery. He told me (once I came out of recovery)) that it was life-saving surgery & said if I had waiting only a couple of hours more, it would have been too late!!

I have been researching it since & it is frequently misdiagnosed or missed as it is sometimes hard to catch. Sometimes it is only discovered during exploratory surgery.

It was once a very rare condition but due to the increase in gastric bypass surgeries, this is on the rise as well.

So please go back & let them know that you have done your research & feel this is what the problem is.

I wish you the best & speedy recovery!

How did you do after your hernia surgery? I just had it four days ago and my stomach is cramping, hurting, and feels just plain weird every time I eat. Is this normal and how long should I expect to feel this way?

Hi

i am literally having exploratory surgery tomorrow for a twisted bowel/ internal hernia.

i know that I have one. I have had sympotoms, pain, bloating, cannot pass has either way, abdominal pain that radiates around to my back, vomiting occurred during the last episode.

I have had issues for the past 2 Years and went to emerg multiple times. Nothing was found. I was told to go see my surgeon who is almost 4 hours away. I finally went last Tuesday, and I was scheduled for surgery one week later.

Go see your surgeon. Apparently if these hernias are not corrected they can be fatal.

My husband had the RNY 2 years ago with great results. Early August he had an internal hernia, with many complications, had to be opened up to repair, followed by AFIB and incision infection which resulted in the incision having to heal from the inside out. 8 days in the hospital and a return visit with AFIB. Dr said full recovery would take 6 months, but he is back to golfing.

Now, 16 weeks later, he is having horrible pain no matter what he eats or drinks and diarrhea for the last 3 weeks, he is also exhausted all the time. We have been back to the ER and had blood work, EKG, CAT Scan and MRI, all coming back normal. This is NOT NORMAL!! Any insight??

Frustrated wife.

What is an update on your husband? I had the internal hernia surgery four days ago and I'm curious. Thank you!