Petersen’s internal hernia complicating a laparoscopic omega loop gastric bypass  Laurent Genser, M.D., Sergio Carandina, M.D., Antoine Soprani, M.D.  Surgery for Obesity and Related Diseases  Volume 11, Issue 5, Pages e33-e34 (September 2015) DOI: 10.1016/j.soard.2015.05.002 Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 1 Transverse CT image shows a cluster of dilated small bowel loops (1) and abnormal course and location of flat intestine in the left mid abdomen (2); (3) rotation of mesenteric vessels (“whirl sign”) with mesenteric fat haziness. Surgery for Obesity and Related Diseases 2015 11, e33-e34DOI: (10.1016/j.soard.2015.05.002) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 2 Petersen’s internal hernia after OLGB. (1) Efferent limb herniated within the Petersen defect; (2) 45° Gastric tube torsion induced by the efferent limb volvulus within the Petersen’s space. Surgery for Obesity and Related Diseases 2015 11, e33-e34DOI: (10.1016/j.soard.2015.05.002) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 3 Petersen’s internal hernia: intraoperative findings before reduction. (1) Transverse colon; (2) Distended small bowel upstream of herniated segment. Surgery for Obesity and Related Diseases 2015 11, e33-e34DOI: (10.1016/j.soard.2015.05.002) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions