scholarly journals Emergency presentation of retrograde intussusception as a late complication of gastric bypass

2012 ◽  
Vol 94 (3) ◽  
pp. e116-e117 ◽  
Author(s):  
R Pande ◽  
I Fraser ◽  
C Harmston
Keyword(s):  
Gastric Bypass ◽  
Rare Complication ◽  
Late Complication ◽  
Emergency Presentation ◽  
Retrograde Intussusception ◽  
First Case ◽  
History Of ◽  
The Uk

Retrograde intussusception is a rare complication of a Roux-en-Y gastric bypass. With the rising number of gastric bypass operations being performed in the UK, the incidence of retrograde intussusception is likely to increase. We report the first case in the UK and highlight its insidious presentation and the importance of considering intussusception in any patient with a history of a Roux-en-Y gastric bypass.

scholarly journals Extra-thoracal migration of the Nuss Bar in corrective surgery for pectus excavatum: a very rare late complication

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Natalie Simon ◽  
Shyam Kolvekar ◽  
Amir Khosravi
Keyword(s):  
Pectus Excavatum ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Late Complication ◽  
Nuss Procedure ◽  
Corrective Surgery ◽  
Chest Wall Deformity ◽  
X Ray ◽  
First Case

Abstract Pectus excavatum is a chest wall deformity with an incidence of around 1 in 400 live births. The Nuss procedure is a surgical intervention that aims to restore functional integrity in these patients. We report the first case of bar migration into the stomach necessitating further surgical intervention for removal. Our case presents a rare complication of pectus excavatum repair and highlights the importance of vigilant follow-up in these patients. If bar migration does occur, imaging in the form of X-ray and CT scans may be of use in early detection in order to expedite management.

scholarly journals Rectal adenocarcinoma with rectoprostatic fistula following prostate brachytherapy

2019 ◽  
Vol 12 (3) ◽  
pp. e226151
Author(s):  
Basil Francis Moss ◽  
Amjad M Peracha
Keyword(s):  
Prostate Cancer ◽  
Rare Complication ◽  
Rectal Adenocarcinoma ◽  
Second Primary ◽  
Prostate Brachytherapy ◽  
Suprapubic Catheter ◽  
Second Primary Cancers ◽  
First Case ◽  
History Of ◽  
Radiation Induced

An 80-year-old man with history of prostate cancer successfully treated with brachytherapy was initially thought to have Fournier’s gangrene until imaging detected a rectoprostatic fistula. Although this is known to be a rare complication of prostate brachytherapy, in this case the aetiology was a new primary rectal adenocarcinoma. It was not possible to catheterise per urethra owing to the fistula, so he was fitted with suprapubic catheter, and underwent palliative loop colostomy. Brachytherapy carries a low risk of second primary cancers, although two previous cases reported such cancers as radiation induced. This is, to our knowledge, the first case of rectal adenocarcinoma following prostate brachytherapy in the literature.

scholarly journals Continuous Glucose Monitoring for Evaluation of Glycemic Excursions after Gastric Bypass

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Florencia Halperin ◽  
Mary Elizabeth Patti ◽  
Megan Skow ◽  
Muhammad Bajwa ◽  
Allison B. Goldfine
Keyword(s):  
Gastric Bypass ◽  
Continuous Glucose Monitoring ◽  
Rare Complication ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Hyperinsulinemic Hypoglycemia ◽  
History Of ◽  
Clinically Significant ◽  
Asymptomatic Subjects ◽  
Tolerance Testing

Background. Hyperinsulinemic hypoglycemia with neuroglycopenia is a rare complication of Roux-en-Y gastric bypass (RYGB). We hypothesized that continuous glucose monitoring (CGM) would be useful to characterize glycemic variability after RYGB.Methods. CGM and mixed meal tolerance testing (MMTT) were performed on sixteen post-RYGB subjects, ten with a history of neuroglycopenia on medical treatment and six asymptomatic controls.Results. 9 of 10 subjects with neuroglycopenia developed hypoglycemia defined by glucose <70 mg/dL on CGM, and 3 of 9 on MMTT. In asymptomatic subjects, 3 of 6 had asymptomatic hypoglycemia during CGM, and 3 of 5 on MMTT. Therefore, the sensitivity and specificity to detect clinically significant hypoglycemia was 90% and 50% for CGM and 33% and 40% for MMTT.Conclusions. Asymptomatic hypoglycemia after RYGB is more frequent than commonly recognized. For clinicians evaluating patients for postbypass neuroglycopenia, CGM may be a valuable diagnostic tool.

scholarly journals Omental Torsion after Laparoscopic Roux-en-Y Gastric Bypass Mimicking Appendicitis: A Case Report and Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-2 ◽  
Author(s):  
Alexandre Descloux ◽  
Giacinto Basilicata ◽  
Antonio Nocito
Keyword(s):  
Gastric Bypass ◽  
Case Report ◽  
Acute Abdomen ◽  
Diagnostic Laparoscopy ◽  
Rare Complication ◽  
Late Complication ◽  
Postoperative Phase ◽  
Review Of The Literature ◽  
Common Procedure ◽  
Omental Torsion

Introduction. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a common procedure in obesity surgery. The aim of an antecolic approach is to reduce the rate of internal herniation. Our aim is to make bariatric surgeons aware of another possible complication of antecolic LRYGBP.Methods and Results. We present a case report of omental torsion 24 months after antecolic LRYGBP presenting as an acute abdomen, suggesting appendicitis. During diagnostic laparoscopy, omental infarction due to torsion was observed. Resection of the avital omentum was performed.Discussion. Omental torsion after antecolic LRYGBP is a rare complication. When appearing in the early postoperative phase, it may mimic an anastomotic leakage. It may also occur as late complication, presenting with acute abdomen as an appendicitis.

scholarly journals Nonfatal Hyperammonemic Encephalopathy as a Late Complication of Roux-en-Y Gastric Bypass

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Juan D. Salcedo ◽  
Jordan S. Goldstein ◽  
Jose M. Quinonez ◽  
Maria Antonietta Mosetti
Keyword(s):  
Gastric Bypass ◽  
Late Complication ◽  
Nutritional Deficiencies ◽  
Prior History ◽  
Time Intervals ◽  
Diagnostic Dilemma ◽  
Hyperammonemic Encephalopathy ◽  
The Us ◽  
History Of ◽  
Common Weight

Roux-en-Y gastric bypass (RYGB) is the most common weight loss procedure performed in the US. Gastric bypass–related hyperammonemia (GaBHA) is a potentially fatal entity, characterized by encephalopathy associated with hyperammonemia and various nutritional deficiencies, which can present at variable time intervals after RYGB. Twenty-five cases of hyperammonemic encephalopathy after bariatric surgery have been previously reported in the literature. We describe the case of a 48-year-old Hispanic woman with no prior history of liver disease, presenting with nonfatal hyperammonemic encephalopathy as a late postoperative complication 20 years after undergoing a RYGB. Hyperammonemic encephalopathy in the absence of known hepatic dysfunction presents a diagnostic dilemma. An early diagnosis and intervention are crucial to decrease morbidity and mortality.

scholarly journals Retrograde Jejunogastric Intussusception (RJGI): A Life- Threatening Complication after Gastric Bypass Surgery

2016 ◽  
Vol 33 (3) ◽  
pp. 161-165
Author(s):  
Imtiaz Faruk ◽  
Sheikh Firoj Kabir ◽  
Syed Mahbubul Alam ◽  
Kh ABM Abdullah Al Hasan
Keyword(s):  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Rare Complication ◽  
Barium Meal ◽  
Type Ii ◽  
Jejunogastric Intussusception ◽  
Life Threatening ◽  
History Of ◽  
Life Threatening Complication

Retrograde jejunogastric intussusception (RJGI) after gastric bypass surgery is a rare but potentially life threatening complication. This complication may develop after simple gastrojejunostomy, after lower partial resection of stomach with gastrojejunostomy (Billroth-II gastric surgery) or after Roux-en-Y gastric bypass. Among the three anatomic type of jejunogastric intussusception (JGI), type-II is the commonest variety. The acute form is a surgical emergency. Mortality rate is very high. Little is known about the mechanism but many literatures indicate abnormal motility may be a cause. A 50 year old male presented to us with a three month history of repeated vomiting and one day of upper mid-abdominal pain. He had a history of gastric bypass for pyloric stenosis 12 years back. Diagnosis was confirmed by upper GI endoscopy. At laparotomy type II retrograde jejunogastric intussusception was identified. En-block resection of affected segment of jejunum and lower part of the stomach was done followed by Roux-en-Y reconstruction. RJGI is a rare complication of gastric bypass surgery. Early diagnosis is imperative. High index of suspicion is therefore important. Barium meal X-ray, ultra sonogram, enhanced CT scan occasionally be diagnostic, but endoscopy is certainly diagnostic in experienced hand. Laparotomy is mandatory. Surgical options include simple reduction, en-block resection and/or plication.J Bangladesh Coll Phys Surg 2015; 33(3): 161-165

scholarly journals A rare case of ventriculoperitoneal shunt knot causing intestinal obstruction in an adult

2019 ◽  
Vol 6 (2) ◽  
pp. 640
Author(s):  
Mayank Bhasin ◽  
Karamjot Singh Bedi ◽  
Tarun Chaudhary ◽  
Gurvansh S. Sachdeva ◽  
Shantanu Kumar Sahu
Keyword(s):  
Intestinal Obstruction ◽  
Ventriculoperitoneal Shunt ◽  
Rare Complication ◽  
Exploratory Laparotomy ◽  
Vp Shunt ◽  
Primary Surgery ◽  
First Case ◽  
Ventriculoperitoneal Shunting ◽  
History Of ◽  
Low Incidence

Despite high incidence of complications, Ventriculoperitoneal shunting for hydrocephalus is the cornerstone and the most common neurosurgical procedure. Ventriculoperitoneal shunt knot causing intestinal obstruction is an extremely rare complication needing surgical intervention. A 19 years old male with history of VP shunting in infancy for hydrocephalus with no history of any revision surgery presented in emergency with pain abdomen and multiple episodes of vomiting for 2 days. X ray showed dilated bowel loops with a coiled up VP shunt in the abdomen. Exploratory laparotomy showed multiple dilated bowel loops with a loop of VP shunt around ileal segment with dense fibrotic adhesions causing obstruction. Extensive adhesiolysis was done. Procedure underwent uneventful. Patient recovered swiftly in postoperative period and is currently asymptomatic after 6 months of surgery. Improved surgery skills and shunt design have prevented much of the morbidity of VP shunting. Most of the cases reported earlier were paediatric patients with history of repetitive handling of catheter. We believe this to be the first case of intestinal obstruction by a VPS knot in an adult with no history of manipulation after primary surgery. Due to low incidence it is difficult to clinically suspect such an extremely rare complication. Therefore, an awareness of VP shunt related complications in adult is essential.

Anastomotic fistula after emergency enterectomy for retrograde intussusception after gastric bypass

2021 ◽  
Vol 14 (5) ◽  
pp. e240756
Author(s):  
Andre Lazaro ◽  
João Simões ◽  
Ana Valente da Costa ◽  
Luis Ventura
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Rare Complication ◽  
Emergency Setting ◽  
Retrograde Intussusception ◽  
The Future ◽  
Anastomotic Fistula ◽  
The Common ◽  
Adequate Management

Retrograde intussusception is a rare complication of gastric bypass. It is commonly located in the common limb close to the jejunojejunostomy. The management of such condition dictates the outcome of the patient either in the immediate emergency setting or in the long-term bariatric surgery’s expected results. We present a case of a retrograde intussusception 3 years after gastric bypass which warranted an emergency enterectomy, followed by an anastomotic fistula. The adequate management of these cases leads to recovery without compromising the effect of bariatric surgery in the future.

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