We present the case of a 44-year-old female with a history of morbid obesity who underwent a laparoscopic Roux-en-Y gastric bypass in 2005.

Her postoperative course was uneventful, and achieved a satisfactory weight loss rate.

Ten months after her surgery, she developed acute onset of abdominal pain, nausea and vomiting. She was admitted to the hospital and placed on IV fluids. The initial assessment demonstrated a dilated alimentary limb on an abdominal computed tomography (CT) scan. She was then taken to the operating room with a preoperative diagnosis of a small bowel obstruction.

This video shows preoperative images of a dilated alimentary limb on an abdominal CT scan, and the surgical technique for an exploratory laparoscopy with lysis of adhesions and the management of an internal hernia. It also demonstrates a small bowel stricture at the jejuno-jejunostomy, with subsequent refashioning of the common channel.