Theodoros Thomopoulos

Highlights • Penetrating injuries to the great abdominal vessels often cause organ damage. • This is the report of an uncommon accidental stab wound. • The wound was successfully managed by prosthetic aortic reconstruction. • Management of the associated visceral damage is also described. • Such lesions require rapid and efficient multidisciplinary team management. Introduction Penetrating injuries to the sub-diaphragmatic aorta are challenging, with high mortality rates.

Abstract Background Small bowel obstruction (SBO) due to internal hernia (IH) is a well-known late complication after laparoscopic Roux-en-Y gastric bypass (LRYGB), with an incidence between 0.5 and 10% as reported by Iannelli et al. (Obes Surg. 17(10):1283–6, 2007). It is reported most frequently 1–2 years after surgery because of the greater weight loss at that time, with rapid loss of the mesenteric fat consequently as discussed by Stenberg et al. (Lancet. 387(10026):1397–404, 2016).