Emergency Endoscopy for Gastrointestinal Bleeding After Bariatric Surgery. Therapeutic Algorithm

García-García, María Luisa; Martín-Lorenzo, Juan Gervasio; Torralba-Martínez, José Antonio; Lirón-Ruíz, Ramón; Perelló, Joana Miguel; Pastor, Benito Flores; Cuadrado, E. Pérez; Albasini, José Luis Aguayo

doi:10.1016/j.cireng.2014.12.009

Cited by 14 publications

(8 citation statements)

References 16 publications

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“…Bleeding from the excluded segments is a rare phenomenon, and while there are no specific clinical guidelines available, several management algorithms have been proposed. 7 To date, there is no consensus about the endoscopic approach.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, upper endoscopy is only considered in cases of rebleeding after conservative management or in patients who present with hemodynamic instability. 7 In cases of gastrointestinal bleeding following RYGB without evident lesions on upper endoscopy, subsequent decisions will depend on the patient's stability and clinical suspicion. In hemodynamically stable patients, a lower origin of bleeding can be ruled-out using colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

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Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report

et al. 2021

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The Roux-en-Y gastric bypass is one of the most extensive surgical treatments for obesity. The treatment of upper gastrointestinal bleeding after Roux-en-Y gastric bypass is complex due to the difficulty of accessing the excluded gastric antrum and duodenal bulb. There is no consensus regarding the management of this complication. While various techniques have been described to access the biliopancreatic limb, double-balloon enteroscopy is the most commonly used. If double-balloon enteroscopy is unavailable, a pediatric colonoscope may be used as an alternative; however, its use in such cases has not been described. We report the case of a 50-year-old male patient who underwent gastric bypass 13 years ago and was admitted for a second episode of upper gastrointestinal bleeding. The initial approach using upper endoscopy, colonoscopy, and abdominal computed tomography angiography did not reveal the cause of gastrointestinal hemorrhage; therefore, an endoscopic study of the biliopancreatic limb was performed using a pediatric colonoscope. A Forrest Ib ulcer was found in the duodenal bulb, and endoscopic therapy was administered. The evolution was found to be satisfactory. Clin Endosc 2021 May 25.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report

et al. 2021

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“…La forma de presentación es similar a la presentación de sangrado gastrointestinal de otras etiologías incluyendo hematemesis o melena. generalmente, la triada de oliguria, taquicardia y caída del hematocrito alerta de un sangrado significativo, que requiere intervención, sea quirúrgica o endoscópica 13,14 . La causa del sangrado temprano generalmente está en las líneas de grapas o sutura en un porcentaje reportado de 74% 11 .…”

Section: Hemorragia Tempranaunclassified

Endoscopía luego de cirugía bariátrica: Lo que debe saber el endoscopista

Díaz¹,

Narvaez

Welsh

et al. 2020

Rev. méd. Chile

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Endoscopy after bariatric surgery: what the endoscopist must know Endoscopy is essential in the assessment and treatment of the bariatric patient, especially in the postoperative state. Since bariatric surgery is increasing exponentially, endoscopists should be familiar with the anatomy and how to manage possible complications. New less invasive therapeutic tools will have a major impact on the prognosis of these patients. Dreaded complications such as leaks, stenosis or weight regain can be successfully assessed and treated by endoscopy. Postoperative evaluation of symptoms requires the precise search of details that can change patient's management.

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“…O sangramento após gastroplastias tem sua principal origem nas bordas do tecido seccionado ou nos locais de penetração dos grampos no tecido. Na GV, costuma decorrer da linha que secciona o estômago, enquanto no BPGY pode ter origem em uma das cinco linhas de grampo: estômago excluído (em até 40% dos casos), bolsa gástrica, alça de Roux, gastrojejunostomia e jejunojejunostomia (6,15,18,21,22) .…”

Section: Sangramentounclassified

“…Uma apresentação menos comum, mas ainda vista na prática, é a obstrução do intestino delgado causada por um coágulo. Abordaremos mais adiante neste artigo a obstrução como complicação (15,18,22,23) .…”

Section: Sangramentounclassified

Complicações cirúrgicas após gastroplastias

Lima

Nóbrega²,

Santos

et al. 2020

RevCienti HMJMA

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O crescimento exuberante do volume de cirurgias bariátricas criou um contingente de pessoas que podem necessitar de atendimento em emergências pelas mais diversas causas, desde casos simples de desconforto abdominal até situações que podem evoluir de forma grave se não forem diagnosticados e tratados com agilidade e segurança. Apresentamos uma breve descrição das principais complicações cirúrgicas após gastroplastias, detalhando o quadro clínico, diagnóstico e terapêutica, com o intuito de despertar interesse no assunto. As alterações anatômicas do trânsito intestinal podem propiciar o surgimento de complicações específicas. Compreender a anatomia e fisiologia das cirurgias e das prováveis complicações possa em muito contribuir para o diagnóstico eficaz e conduta terapêutica efetiva a tempo de reduzir maiores agravantes.

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Emergency Endoscopy for Gastrointestinal Bleeding After Bariatric Surgery. Therapeutic Algorithm

Cited by 14 publications

References 16 publications

Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report

Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report

Endoscopía luego de cirugía bariátrica: Lo que debe saber el endoscopista

Complicações cirúrgicas após gastroplastias

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