Management of High Output Enterocutaneous Fistula Due to Richter’s Hernia After Gastric Bypass: Video Demonstration

Abstract

Introduction: The increase in laparoscopic surgery in patients with obesity increases the incidence of trocar site hernia (TSH). Therefore, TSH represents a risk for the development of Richter’s Hernia (RH). Methods: We present the unusual case of a postoperative Gastric Bypass patient complicated with a high output enterocutaneous fistula through a trocar site wound. Results: The Laparoscopic surgery consists of an RH reduction, enterotomy, and repair of the preperitoneal space. Conclusion: RH complicated by high-output enterocutaneous fistula has not been previously reported. It is essential to close the preperitoneal space in bariatric surgery to avoid these complications.