scholarly journals Gastric volvulus post sleeve gastrectomy converted to gastric bypass in pregnancy: a case report

2018 ◽  
Vol 5 (11) ◽  
pp. 3754
Author(s):  
Baillie W. C. Ferris

Complications arising from revision bariatric surgery can be complex due to altered anatomy. This is especially the case in a bariatric patient who becomes pregnant. I present an interesting case of a female patient who suffered a gastric volvulus during pregnancy after having had revision gastric bypass surgery 3 years prior, secondary to an internal hernia. This case highlights that revision bariatric surgery attracts a higher rate of complication, both preoperatively and long term, as well as highlighting the need for a high degree of suspicion for rare causes of abdominal pain in patients post bariatric surgery. Pregnancy is also an added risk factor for these patients.

2020 ◽  
Author(s):  
Cristina Fiorani ◽  
Sophie R. Coles ◽  
Myutan Kulendran ◽  
Emma Rose McGlone ◽  
Marcus Reddy ◽  
...  

Abstract Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have been shown to improve metabolic comorbidities as well as quality of life (QoL) in the obese population. The vast majority of previous studies have investigated the metabolic effects of bariatric surgery and there is a dearth of studies examining long-term QoL outcomes post bariatric surgery. The outcomes of 43 patients who underwent bariatric surgery were prospectively assessed, using BAROS questionnaires to quantify QoL and metabolic status pre-operatively, at 1 year and at 8 years. Total weight loss and comorbidity resolution were similar between RYGB and SG. The RYGB cohort experienced greater QoL improvement from baseline and had higher BAROS scores at 8 years. RYGB may provide more substantial and durable long-term benefits as compared to SG.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4930-4930
Author(s):  
Vaishali R. Doshi ◽  
Raymond Thertulien

Abstract Introduction: Bariatric Surgery is promoted as a successful method for weight loss and is performed with increasing frequency. The benefits and the short term risks of the surgical procedure are well understood. However, its long term pathophysiological consequences are still for the most part unknown. They may include metabolic changes that result in malnourishment and malabsorption. Deficiency disorders of iron, B-12 and folate are commonly encountered. However hematological problems from copper deficiency due to malabsorption have not been well studied. Background: Copper and Iron are essential trace elements through their functions as co-factors in numerous biochemical reactions. Hephaestin, a transmembrane copper-dependent ferroxidase, is necessary for effective iron transport from intestinal enterocyte into the circulation. Copper is hence required for iron absorption. Copper enzymes such as superoxide dismutase and cytochrome oxidase have an essential role in red cell development and heme maturation. Patients and Method: We present data on five patients referred for treatment of myelodysplasia whose evaluation revealed copper deficiency and low ceruloplasmin level. All five patients were female and had undergone gastric bypass surgery for weight reduction. The hematological features included pancytopenia, erythroid hyperplasia and dysplasia with increased blasts mimicking erythroleukemia, multilineage dysplasia with ring sideroblasts, bilineage megakaryocytic and erythroid dysplasia. One patient presented with neutropenia and anemia with a normal bone marrow; she was found to have copper deficiency. No cytogenetic abnormalities were observed and the patients had normal B-12 and folate. Copper gluconate was started at 20 mg/day by mouth, with weekly monitoring, till normal levels were reached. Patients were subsequently maintained at 5–10 mg/day with regular monitoring. Upon repletion of copper, all the patients recovered with normalization of the bone marrow and peripheral counts. Discussion: We conclude that Gastric bypass especially Roux-en-Y gives rise to copper deficiency due to malabsorption in the duodenum and can present as pseudomyelodysplasia. We consider measurement of copper and ceruloplasmin levels an important component of the evaluation of patients presenting with myelodysplasia with normal cytogenetics, especially after gastric bypass.


2017 ◽  
Vol 152 (5) ◽  
pp. S1274
Author(s):  
Andrew D. Wisneski ◽  
Jonathan Carter ◽  
Eric K. Nakakura ◽  
Andrew Posselt ◽  
Kenzo Hirose ◽  
...  

2020 ◽  
Author(s):  
Hannes Beiglböck ◽  
Paul Fellinger ◽  
Tamara Ranzenberger-Haider ◽  
Greisa Vila ◽  
Anton Luger ◽  
...  

2020 ◽  
Author(s):  
Roman Vangoitsenhoven ◽  
Rickesha Wilson ◽  
Deepa V Cherla ◽  
Chao Tu ◽  
Sangeeta R Kashyap ◽  
...  

<b>Objective</b>: Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR) and beta-cell dysfunction. Ectopic fat accumulation in liver and muscle causes IR. Since bariatric and metabolic surgery significantly improves fatty liver disease, <a>we hypothesized that coexistence of liver steatosis (i.e., when hepatic IR contributes in T2DM) would be associated with greater diabetes improvement after surgery.</a> <p> </p> <p><b>Research design and methods</b>: A total of 519 patients with T2DM who underwent Roux-en-Y gastric bypass and simultaneous liver biopsy and had a minimum 5-year follow-up were analyzed to assess the independent association between biopsy-proven liver steatosis and postoperative long-term diabetes remission (glycated hemoglobin < 6.5% off medications).</p> <p> </p> <p><b>Results</b>: Of the 407 patients with biopsy-proven liver steatosis, long-term diabetes remission was achieved in 211 (52%) patients, compared with 44/112 (39%) remission in patients without steatosis (P=0.027). In multivariable analysis, presence of liver steatosis was an independent predictor of long-term diabetes remission (odds ratio 1.96, [95% confidence interval 1.04 – 3.72], <i>P</i>=0.038). Hepatocyte ballooning, lobular inflammation, or fibrosis at baseline did not predict diabetes remission.</p> <p> </p> <p><b>Conclusion</b>: This study, for the first time, suggests that in patients with T2DM who are considering bariatric and metabolic surgery, coexistence of liver steatosis is associated with better long-term glycemic outcomes. Furthermore, our data suggest that there are different variants of T2DM wherein metabolic responses to surgical weight loss are different. A subgroup of patients whose T2DM is characterized by the presence of hepatic steatosis (presumably associated with worse IR) experience better postoperative metabolic outcomes.</p>


2021 ◽  
Author(s):  
Fardowsa Mohamed ◽  
Megna Jeram ◽  
Christin Coomarasamy ◽  
Melanie Lauti ◽  
Don Wilson ◽  
...  

Abstract Introduction Obesity increases the risk of pelvic floor disorders in individuals with obesity, including faecal incontinence. Faecal incontinence (FI) is a condition with important clinical and psychosocial consequences. Though it is associated with obesity, the effect of bariatric surgery on the prevalence and severity of FI is not well reported. Objective To assess the effect of bariatric surgery on the prevalence and severity of FI in adult patients with obesity. Methods This systematic review was conducted in accordance with the PRISMA statement. Two independent reviewers performed a literature search in MEDLINE, PubMed, Cochrane and Embase from 1 January 1980 to 12 January 2019. We included published English-language randomized control trials and observational studies assessing pre- and post-bariatric surgery prevalence or severity of FI. Random-effects models with DerSimonian and Laird’s variance estimator were used for meta-analysis. Results Thirteen studies were included, eight assessing prevalence (678 patients) and 11 assessing severity of FI (992 patients). There was no significant difference in prevalence post-operatively overall, though it trended towards a reduction [pooled OR=0.55; =0.075]. There was a significant reduction of FI prevalence in women post-bariatric surgery [95% CI 0.22 to 0.94, p=0.034]. There was a statistically significant reduction in FI prevalence following Roux-en-Y gastric bypass and one anastomosis gastric bypass [0.46, 95% CI 0.26 to 0.81; p=0.007]. There was no significant reduction of incontinence episodes post-operatively [pooled mean difference =−0.17, 95% CI −0.90 to 0.56; p=0.65]. Quality of life (QOL) was not significantly improved post-bariatric surgery [mean differences for the following facets of QOL: behaviour −0.35, 95% CI −0.94 to 0.24; depression 0.04, 95% CI −0.12 to 0.2; lifestyle −0.33, 95% CI −0.98 to 0.33; p values of 0.25, 0.61 and 0.33, respectively]. Discussion There was a significant reduction in FI prevalence in women and those who underwent Roux-en-Y or one anastomosis gastric bypass. Our results for FI prevalence overall, FI severity and impact on quality of life were not statistically significant. Larger studies are needed in this under-researched area to determine the true effect of bariatric surgery on FI. Graphical abstract


2021 ◽  
Author(s):  
Larissa Cristina Lins Berber ◽  
Mariana Silva Melendez-Araújo ◽  
Eduardo Yoshio Nakano ◽  
Kênia Mara Baiocchi de Carvalho ◽  
Eliane Said Dutra

2012 ◽  
Vol 256 (6) ◽  
pp. 1023-1029 ◽  
Author(s):  
Amanda Jiménez ◽  
Roser Casamitjana ◽  
Lílliam Flores ◽  
Judith Viaplana ◽  
Ricard Corcelles ◽  
...  

Author(s):  
Manish Khaitan ◽  
Riddhish Gadani ◽  
Koshish Nandan Pokharel

<b><i>Objectives:</i></b> The growing prevalence of obesity rates worldwide is associated with an upsurge in its comorbidities, particularly type 2 diabetes mellitus (T2DM). Bariatric surgery is a proven treatment modality for producing sustained weight loss and resolution of associated T2DM providing marked improvement in quality of life with rapid recovery. This study aims to investigate the effects of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and mini-gastric bypass (MGB) on obese patients suffering from T2DM in the Indian population and their long-term association with regard to diabetes remission, resolution of comorbidities, and percentage EWL. <b><i>Methods:</i></b> Retrospective data of obese patients with T2DM (preoperative BMI 45.37 ± 8.1) who underwent bariatric surgery (RYGB, LSG, and MGB) were analyzed in this study over a period of 9 years. The mean follow-up period was 2.2 years. Following surgery, the clinical outcome on BMI, resolution of percentage weight loss, and T2DM were studied. The predictive factors of diabetic remission after surgery were determined. Student’s <i>t</i> test and ANOVA and McNemar’s test were applied. <b><i>Results:</i></b> Out of a total of 274 patients, complete remission of T2DM was achieved in 52.9% (<i>n</i> = 145) with mean fasting blood glucose and glycated hemoglobin values being 6.1 ± 0.769 (<i>p</i> = 0.00) at 1 year after surgery. The independent predictive factors of remission were age, gender, BMI, preoperative comorbidities, and % EWL. Gender had no correlation with the chance of achieving disease remission. <b><i>Conclusion:</i></b> Based on our results, bariatric surgery proves to be a successful treatment option resulting in sustained weight loss in obese patients suffering from T2DM. It is found to be beneficial for the long-term resolution of T2DM and improving comorbidities such as hypertension and dyslipidemia. The outcome of the different surgical methods is found to be similar for all patients irrespective of the independent predictors of complete remission.


Sign in / Sign up

Export Citation Format

Share Document