Background

A 61-year-old female with a past medical history significant for morbid obesity status post Roux-en-Y gastric bypass presented with abdominal pain and concern for bowel obstruction. The patient was found to have a band around the terminal ileum and transverse colon causing an internal hernia with a closed-loop obstruction of the right colon and terminal ileum. The band was resected and the internal hernia was reduced. There was a separate band connecting the sigmoid colon to this mesenteric band around the transverse colon which was also ligated.