Delayed presentation of trocar site hernia following single anastomosis sleeve-ileal (SASI) bypass

A 56-year-old woman was admitted with intractable vomiting 3 months after Single Anastomosis Sleeve-Beal (SASI) bypass without trocar site fascial repair. Laboratory data showed no abnormalities. An intravenous-oral CT scan of abdominopelvic region showed small bowel loop herniation through the 12mm left-sided trocar, where the specimen was extracted. As a result, a diagnostic laparoscopy was done. Due to the severe adhesions at the site of trocar site hernia, multiple serosal injuries were encountered during enterolysis so small bowel resection and primary anastomosis of a 5 cm segment of jejunum was performed. The symptoms subsided after surgery. We present the first case of trocar site hernia following the SASI bypass with late-onset presentation of postoperative emesis.