Biliopancreatic diversion with duodenal switch (BPD-DS) and single anastomosis duodeno-ileostomy with sleeve (SADI-S) are associated with superior and sustained weight loss outcomes. Despite their growing popularity, long-term safety profiles, particularly the risk of internal hernia (IH), remain underexplored. This study aimed to evaluate the incidence and characteristics of IH following BPD-DS and SADI-S procedures, comparing their clinical presentation, diagnostic methods, and outcomes. A retrospective chart review was performed for patients who underwent BPD-DS or SADI-S between 2008 and 2023 in two high-volume tertiary referral centres for bariatric surgery in the United States. Demographic data, comorbidities, operative details, and follow-up outcomes were collected. A subgroup analysis of IH cases was conducted to compare the incidence, location of hernias, and diagnostic modalities between procedures. Out of 1160 patients (85.1% BPD-DS; 14.9% SADI-S), the overall incidence of IH was 1.12%, with a higher rate in BPD-DS (0.8%) than in SADI-S (0.57%). Most IHs occurred within the first 24 months postoperatively. The majority of IHs in BPD-DS patients were in the pseudo-Petersen's space. The single IH case in the SADI-S group occurred in the same space. Most patients presented with abdominal pain and were diagnosed by CT imaging. SADI-S showed a lower IH rate compared to BPD-DS, but further studies are needed to confirm these findings. The variability in clinical presentation complicates the diagnosis of IH, emphasizing the need for increased clinical vigilance.

Romulo P. Lind

Graziella Galvao Goncalves

Amanda Belluzzi

Karl Hage

Juliana Antunes

Muhammad Ghanem

Muhammad A. Jawad

Michael Kendrick

Omar M. Ghanem

Andre F. Teixeira

Clinical Obesity

Clinical Obesity is an international peer-reviewed journal publishing high quality translational and clinical research papers and reviews focussing on obesity and its co-morbidities.    Key areas of interest are:    • Patient assessment, classification, diagnosis and prognosis  • Drug treatments, clinical trials and supporting research  • Bariatric surgery and follow-up issues  • Surgical approaches to remove body fat  • Pharmacological, dietary and behavioural approaches for weight loss  • Clinical physiology  • Clinically relevant epidemiology  • Psychological aspects of obesity  • Co-morbidities  • Nursing and care of patients with obesity.

Clinical Obesity is an international peer-reviewed journal that publishes high-quality translational and clinical research papers and reviews focusing on obesity and its comorbidities. Key areas of interest include: • Patient assessment, classification, diagnosis, and prognosis • Drug treatments, clinical trials, and supporting research • Bariatric surgery and follow-up issues • Surgical approaches to remove body fat • Pharmacological, dietary, and behavioral approaches for weight loss • Clinical physiology • Clinically relevant epidemiology • Psychological aspects of obesity • Comorbidities • Nursing and care of patients with obesity.

《Clinical Obesity》是一本国际同行评审的期刊，致力于发表高质量的转化医学和临床研究论文以及关于肥胖及其相关疾病的综述。期刊关注的主要领域包括：• 患者评估、分类、诊断和预后 • 药物治疗、临床试验及相关研究 • 减肥手术及其后续问题 • 移除体脂的外科方法 • 药物、饮食和行为干预的减重策略 • 临床生理学 • 相关流行病学 • 肥胖的心理学因素 • 相关疾病 • 肥胖患者的护理与照顾。

Internal hernia in patients after duodenal switch: A multi‐centred comparative analysis

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Journal Info

Category	Quartile
ENDOCRINOLOGY & METABOLISM	3