Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass

Felsher, Joshua; Brodsky, Jason; Brody, Fred

doi:10.1067/s0039-6060(03)00251-4

Cited by 97 publications

(67 citation statements)

References 9 publications

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“…Although internal hernias can cause bowel obstruction, they more commonly lead to compression of the mesentery with resultant intestinal ischemia, resulting in abdominal pain out of proportion to physical exam findings which may be acute or chronic, post-prandial or colicky [42]. Many surgeons advocate suture closure of these potential spaces at the initial operation to prevent future occurrence of internal hernias [37,41,43]. Radiographic findings include the characteristic ''swirl sign'' where the blood vessels of the twisted mesentery form a swirled spiral on contrast-enhanced CT.…”

Section: Gastrointestinal Obstructionmentioning

confidence: 97%

“…Gastrointestinal obstruction is a relatively uncommon complication after RYGB, with a reported incidence of 1.5-5.0% [32][33][34][35][36][37]. There are many potential causes of obstruction, including anastomotic edema or kinking, peritoneal adhesive bands, internal hernia, jejunal intussusception, and bezoar formation in the gastric pouch [38,39].…”

Section: Gastrointestinal Obstructionmentioning

confidence: 99%

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Complications of Roux-en-Y gastric bypass and sleeve gastrectomy

Herron

Roohipour²

2012

Abdom Radiol

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Roux-en-Y gastric bypass and sleeve gastrectomy are two of the most common bariatric procedures performed in 2011. Although the complication rates associated with these procedures are low, the consequences of these complications are significant and can be associated with high morbidity and mortality. Timely diagnosis and proper management of these complications are extremely important. The most commonly used radiologic studies in bariatric surgery are the upper GI contrast study and the CT scan, which are used to rule out leak, obstruction, perforation, anastomotic stricture, or pouch dilatation. As with all imaging studies, a negative result should not override strong clinical suspicion of a complication.

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Section: Gastrointestinal Obstructionmentioning

confidence: 97%

Section: Gastrointestinal Obstructionmentioning

confidence: 99%

Complications of Roux-en-Y gastric bypass and sleeve gastrectomy

Herron

Roohipour²

2012

Abdom Radiol

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“…Excessive suturing at the site of this defect could cause mesocolic tunnel stenosis and obstruction of the Roux limb. This complication is seen in 1-2% cases following RYGBP [13,15,26]. It does not occur with antecolic placement of the Roux loop, though the latter technique has a higher incidence of gastrojejunostomy strictures [13].…”

Section: Mesocolic Tunnel Stenosismentioning

confidence: 98%

Gastrointestinal complications of bariatric Roux-en-Y gastric bypass surgery

et al. 2004

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Obesity is rapidly becoming the most important public health issue in USA and Europe. Roux-en-Y gastric bypass is now established as the gold standard for treating intractable morbid or super obesity. We reviewed the imaging findings following this surgery in 234 patients. In this pictorial essay we present the CT and upper gastrointestinal contrast study appearances of the expected postoperative anatomy as well as a range of abdominal complications. The complications are classified into leaks, fistula and obstruction. Postoperative gastric outlet and small bowel obstruction can be caused by anastomotic stenosis, mesocolic tunnel stenosis, adhesions, stomal ulcer, obturation, intussusception and internal or external hernia. Small bowel obstruction may be of a simple, closed loop and/or strangulating type. The radiologist should be able to diagnose the type and possible cause of obstruction.

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“…12 Obstruction resulting from intramural blood clot formation in the small intestine is caused by inadequate hemostasis at the stapled anastomosis and is rarely seen in the immediate postoperative period. 12 In general, a hematoma undergoes spontaneous reabsorption in 14 to 90 days, 13 making surgical intervention seldom necessary. Hence the treatment for intramural hematoma is nonoperative, 13 and because most of these hematomas resolve spontaneously, 13,14 surgical management is infrequently required.…”

Section: Discussionmentioning

confidence: 99%