As gallstones often occur following RYGB, there is controversy regarding their management. Some authors propose systematic cholecystectomy along with RYGB, while others suggest that the aggregate risk of the concomitant approach is significantly higher. As IR was a significant risk factor in this study, an individualized approach for this population may be proposed. Further research is needed to confirm these findings.

BackgroundAsthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease.AimTo analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma.MethodsWere reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma. The variables considered were: gender, age, gastroesophageal symptoms (heartburn, acid reflux and dysphagia), time of reflux disease, treatment with proton pump inhibitor, use of specific medications, treatment and evolution, number of attacks and degree of esophagitis. Data were subjected to statistical analysis, comparing the pre- and post-surgical findings.ResultsThe comparative analysis before surgery (T1) and six months after surgery (T2) showed a significant reduction on heartburn and reflux symptoms. Apart from that, there was a significant difference between the patients with daily crises of asthma (T1 versus T2, 45.83% to 16.67%, p=0.0002) and continuous crises (T1, 41.67% versus T2, 8.33%, p=0.0002).ConclusionLaparoscopic Nissen fundoplication was effective in improving symptoms that are typical of reflux disease and clinical manifestations of asthma.

HighlightsHe experienced a long gap without symptoms that were relieved following the surgery performed in his infancy. Nonetheless, no biopsy examination from the duodenum has been done preoperatively. It could explain the delay in reaching the definitive diagnosis.We submitted him to two surgeries.Every patient that comes from an endemic area for Strongyloides stercoralis the hypothesis of strongyloidiasis should be considered and biopsies on stomach and duodenum should be made.

Patient: Male, 27Final Diagnosis: Obstructive gastric pseudotumorSymptoms: Dyspepsia • weight lossMedication: GanciclovirClinical Procedure: Infectious diseases treatments and surgical treatmentSpecialty: Gastroenterology and HepatologyObjective:Rare co-existance of disease or pathologyBackground:Cytomegalovirus (CMV) is a common opportunistic pathogen in patients with HIV. It is also a major cause of gastrointestinal ulcers in patients with acquired immunodeficiency syndrome (AIDS). CMV pseudotumor in the stomach is a rare cause of digestive tract obstruction.Case Report:In this study we report a male patient infected with HIV in 2002. In 2014 he evolved C3 stage AIDS with prepyloric gastric ulcer which provoked deformity and pseudotumoral aspect of the gastric outlet. Endoscopic biopsy confirmed CMV infection. He underwent Roux-en-Y gastroenteroanastomosis with good recovery.Conclusions:CMV infection should be considered as an agent in gastric lesions in HIV-infected patients. Roux-en-Y gastroenteroanastomosis is a surgical option for this group of patients, allowing improvements in quality of life and decreasing risks of perioperative complications.