Elective Repair of Atypical Internal Hernia Following Roux-En-Y Gastric Bypass in a Patient With Recurrent Obstructive Symptoms: A Case Report.

Internal hernias are a well-recognized but potentially life-threatening complication following Roux-en-Y gastric bypass (RYGB). Diagnosis is often delayed due to non-specific symptoms and limitations of imaging, and surgical repair is frequently required. We present the case of a 47-year-old male with a history of RYGB who developed an atypical type of recurrent internal hernia, ultimately managed with elective exploratory laparotomy, reduction of hernia, closure of mesenteric defect and mesh repair of a concurrent incisional hernia. This case highlights the diagnostic challenges, surgical considerations, and importance of elective intervention in patients with a history of previous internal hernia repair post-bariatric surgery and presenting with recurrent subacute obstruction.