Gastric remnant perforation after single anastomosis gastric bypass

Abstract

Introduction: Acute perforation of gastric remnants after single anastomosis gastric bypass are scarcely reported in the literature. The leak of gastrointestinal contents into the abdomen increases morbidity and if not promptly recognized can lead to mortality from sepsis. Case Report: A 42-year-old male developed abdominal pain and fever after laparoscopic removal of adjustable gastric band, hiatus hernia repair, and single anastomosis gastric bypass. Computed tomography showed evidence of viscus perforation, bowel obstruction, and intra-abdominal infection. Operative findings suggested bowel obstruction of the afferent small bowel loop led to perforation at the gastric remnant staple line which was repaired primarily. Conclusion: Patients presenting with early sepsis after single anastomosis gastric bypass should be investigated with computed tomography. Gastrointestinal leaks should be promptly addressed with surgical washout, primary repair, and suture reinforcement.