Internal Hernia after Distal Gastrectomy for Gastric Cancer Triggered by Retroperitoneal Recurrence

: A 77-year-male who had undergone distal gastrectomy with Roux-en-Y reconstruction received the tegafur/gimeracil/ oteracil adjuvant chemotherapy for about 1 year. 32 months after surgery, liver hilus lymph nodes and peritoneal recurrence were found. For obstructive jaundice, the metallic stent was implanted under double balloon-ERCP(DB-ERCP). He was treated 13 courses with SOX, preceded PTCD and re-implanted metallic stent for re-obstructive jaundice 52 months after the initial surgery. Although the jaundice was improved, he came to vomit after meal. Abdominal computed tomography revealed internal hernia. He had undergone the operation on the 8th hospital day. The hernial orifice was found in the mesentery defect due to peritoneal recurrence. He was able to eat after that operation but he was passed away POD-85 by the primary disease.