Minal patel
Minal Chetan Kumar Patel survives after her bariatric surgery for weight loss had resulted in a rare hernia that could have turned fatal.

Dubai: Surgeons at a Dubai hospital were able to save the life of a young woman whose bariatric surgery for weight loss had resulted in a rare hernia that could have turned fatal.

Minal Chetan Kumar Patel, 38, an Indian realtor and resident of Dubai, had travelled to India for her bariatric surgery in 2017. After the surgery, Patel was happy as she lost a considerable amount of weight. She shed more weight in the following two years and was able to excel in her job as a property consultant.

However, in March, Patel was rushed to the Emergency Room of Aster Hospital, Qusais with severe abdominal pain and bouts of vomiting.

Misunderstood as food poisoning

Patel thought it was food poisoning and it never occurred to her that this was a complication arising out of her bariatric procedure carried out nearly five years ago.

It was not the first time Patel had experienced abdominal pain post the bariatric surgery. Patel told Gulf News: “I used to get the pain occasionally. However, I thought I was suffering from a bad reaction to food that did not agree with me. The pain would last for a day, and then subside. Therefore, I neglected those symptoms and continued with my daily routine.”

Poor blood supply

At Aster Hospital, Qusais, on advice of the emergency doctor, Patel underwent a CT scan. The scan revealed intestinal ischemia, a serious condition caused due to an insufficient supply of blood flow to the intestines. Patel was referred to Dr Sudheer Salavudeen, specialist general surgery at the hospital, who elaborated on the case.

Contorted intestines

Dr Sudheer Salavudeen

Minal’s test results indicated that she had an obstruction in the blood supply to her intestines. To understand the cause in detail, we performed a laparoscopy procedure that gave us real-time footage of the intestines. During the procedure, we saw that her intestines were contorted and circling in loops. These contortions were the result of the gastric bypass bariatric surgery she had undergone about five years ago,” said Dr Salavudeen.

He added that they found milky fluid filling the spaces between the intestinal loops. The laparoscopy footage showed that the intestines were herniating into the ‘Petersen’s space’ in the abdomen.

‘Rarest of rare hernia’

“The milky fluid was actually Chyle, which is a mixture of lymph and emulsified fats. Minal’s was a classic case of Petersen’s Hernia. This is a rare condition. A very few people develop the complication following a gastric bypass procedure. It requires an immediate surgical intervention, as the chances for dilation and tear are more. It was fortunate that this patient came to us at the nick of time,” said Dr Salavudeen.

Dr Salavudeen and his team cleared the contortions in the intestine of the patient and Patel was kept under observation in the ICU for two days. The doctor also diagnosed her with electrolyte imbalance and anaemia. Medicines and supplements were prescribed, and Patel was discharged by March 18.

Speaking of her condition after the procedure, Patel said: “I am doing very well now. I do not feel any pain. I am thankful to Dr Sudheer and his team at Aster for their proper diagnosis of the condition and the right treatment.”

What is Petersens’ Hernia?
This condition is named after the German surgeon Dr Walther Peterson, who first described this condition. Petersen’s Hernia can occur typically after a bariatric surgery due to a bulge between the limb of the bypass and the colon. This literally strangulates part of the intestinal loops, cutting off blood supply. The patient suffers from fever, fatigue, nausea, and excruciating pain and the hernia is visible as bulge on the left upper abdomen. The chances of suffering this condition is between one to nine per cent in patients who undergo bariatric surgery for either weight loss and if left unattended can be fatal.
Source: Dr Sudheer Salavudeen