Delayed perforation of the defunctionalized stomach after Roux-en-Y gastric bypass surgery

Arshava, Evgeny V.; Mitchell, Cassidy D.; Thomsen, Timothy; Wilkinson, Neal

doi:10.1016/j.soard.2006.05.001

Cited by 12 publications

(7 citation statements)

References 14 publications

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“…Thus, other factors might have a higher impact on ulcer formation. [11] 0/2 36 3 n/a Y n/a 54 0.2 n/a n/a n/a Bjorkman [12] 0/1 24 6 n/a N n/a Braley [13] 2/1 49 17 n/a n/a n/a 59 17 n/a n/a n/a 49 16 n/a n/a n/a Dai [9] 1 / 0 5 4 5 N N n e g Eid [14] 0/1 61 10 N N n/a Gypen [15] 1/0 35 0.2 n/a n/a pos Husain [16] 1/0 63 1.5 n/a n/a n/a Iranmannesh [28] 4 [24] 0/1 48 4 n/a n/a n/a Zagzag [27] 5/0 57 5 n/a n/a pos 54 12 n/a n/a pos 53 9 n/a n/a neg 47 0.7 n/a n/a n/a…”

Section: Role Of Ppimentioning

confidence: 99%

Ulcer Disease in the Excluded Segments after Roux-en-Y Gastric Bypass: a Current Review of the Literature

et al. 2020

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Ulcer disease in excluded segments after Roux-Y gastric bypass (RYGB) is rare but can evolve into a life-threatening situation. The excluded segments exhibit a different behavior from that of non-altered anatomy; perforated ulcers do not result in pneumoperitoneum or free fluid, and therefore must be met with a low threshold for surgical exploration. The anatomical changes after RYGB impede routine access to the remnant stomach and duodenum. There are various options to address bleeding or perforated ulcers. While oversewing and drainage preserves the anatomy and forgoes resection, remnant gastrectomy offers a definitive solution. The importance of traditional risk factors such as smoking or use of non-steroidal anti-inflammatory drugs is unclear. Eradication of Helicobacter pylori and secondary prophylaxis with proton-pump inhibitors is advisable, albeit in double-dose.

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Section: Role Of Ppimentioning

confidence: 99%

Ulcer Disease in the Excluded Segments after Roux-en-Y Gastric Bypass: a Current Review of the Literature

et al. 2020

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“…Out of the 23 cases reported, air under the diaphragm has been reported in only one of the cases. [22–24] This is because the air in the bypassed remnant stomach is absorbed in the post-operative period, except in cases of gastrogastric fistula and an obstruction distal to an enteroenterostomy. Hence, it is important for the physician to understand that perforation in bariatric surgery patients can present without the usual clinical and radiological signs.…”

Section: Management Of Complicated Duodenal Ulcersmentioning

confidence: 99%

“…The remnant stomach and duodenum have multiple full thickness necrotic patches with only 1 cm of duodenum around the ampulla of vater viable. [22]…”

Section: Management Of Complicated Duodenal Ulcersmentioning

confidence: 99%

Effect of bariatric surgery on future general surgical procedures

Kini

Kannan

2011

J Min Access Surg

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Bariatric surgery is now accepted as a safe and effective procedure for morbid obesity. The frequency of bariatric procedures is increasing with the adoption of the laparoscopic approach. The general surgeons will be facing many more of such patients presenting with common general surgical problems. Many of the general surgeons, faced with such situations, may not be aware of the changes in the gastrointestinal anatomy following bariatric procedures and management of these clinical situations will therefore present diagnostic and therapeutic challenges. We hereby present a review of management of few common general surgical problems in patients with a history of bariatric surgery.

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“…Although rare, complications such as bleeding, perforation and ischemia occur regarding the remnant stomach [1]. In a study, it was stated that the incidence of non-functioning remnant gastric perforation was 0.25% [2].…”

mentioning

confidence: 99%

“…The surgical treatment of remnant gastric perforations varies in the literature. There are cases with primary closure, omentopexy or resection [1,2].…”

mentioning

confidence: 99%

A rare long-term complication in a patient with gastric bypass: remnant gastric perforation

Erdoğdu

TEZER

et al. 2022

The European Research Journal

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Roux-en-Y gastric bypass (RYGB), one of the most frequently performed operations within the scope of bariatric surgery, creates a remnant stomach containing the fundus, corpus and antrum where gastric acid and pepsinogen are synthesized in significant amounts. Although rare complications such as bleeding, perforation and ischemia occur regarding the remnant stomach. A 47-year-old male patient who was operated on for open RYGB 10 years ago was admitted to the emergency department with complaints of abdominal pain and deterioration in his general condition. The patient who had widespread tenderness in the abdomen was unstable on physical examination. It was observed that the remnant stomach was perforated 2.2 cm from the anterior surface of the corpus at emergency laparotomy after defining the upper gastrointestinal anatomy with the aid of peroperative endoscopy. The patient whose remnant stomach was resected was discharged uneventfully on the 5th postoperative day. The approach to remnant gastric perforations due to benign causes is the same as for gastric perforations. Laparotomy is indicated in unstable patients.

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Delayed perforation of the defunctionalized stomach after Roux-en-Y gastric bypass surgery

Cited by 12 publications

References 14 publications

Ulcer Disease in the Excluded Segments after Roux-en-Y Gastric Bypass: a Current Review of the Literature

Ulcer Disease in the Excluded Segments after Roux-en-Y Gastric Bypass: a Current Review of the Literature

Effect of bariatric surgery on future general surgical procedures

A rare long-term complication in a patient with gastric bypass: remnant gastric perforation

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