Although rare, internal hernias have an increased incidence of development in patients who have undergone Roux-en-Y gastric bypass. They are difficult to diagnose given their non-specific presentation and lack of externally visible findings, and most cases develop within a few months of the original procedure. In this case report, we present a patient with recent weight loss who developed an internal hernia decades post-bariatric surgery with computed tomography findings showing the classic "mesenteric swirl" sign.
