scholarly journals Surgical Management of a Caustic Ingestion in a Gastric Bypass Patient: A Case Report

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Van Boxstael E ◽  
◽  
Terwagne N ◽  
Deswysen Y ◽  
◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Suicide Attempt ◽  
Surgical Management ◽  
Gastric Pouch ◽  
Psychological Disorders ◽  
Exploratory Laparotomy ◽  
Caustic Ingestion ◽  
Alimentary Limb ◽  
Gastric Bypass Patient

Introduction: Bariatric surgery is recognized as the most effective treatment for obesity. Increased rate of psychological disorders has been noted after surgery. However, no case of caustic ingestion after bariatric surgery and its surgical management has been reported in the literature. Presentation of Case: A 48-year-old woman, who underwent a Rouxen- Y gastric bypass 9 years ago, ingested caustic substances as a suicide attempt, causing necrosis of the entire alimentary limb without severe lesion of esophageal tract or gastric pouch. During exploratory laparotomy, resection of the alimentary limb and gastrostomy in the neogastric pouch were performed. Three months later, the patient presented to the emergency room with a dislodged gastrostomy tube. Exploratory laparotomy was performed with restoration of anatomical continuity via gastro-gastric anastomosis. Discussion: Bariatric surgery is correlated to a higher postoperative risk of psychological disorders until suicide attempt. This case is the first description of caustic ingestion after Roux-en-Y gastric bypass and its surgical management. It underlines the importance for bariatric teams to consider psychological aspect of surgical patients pre- and postoperatively.

SFR-118 Surgical management of gastrogastric fistulas in the Roux-en-Y gastric bypass patient

2011 ◽  
Vol 7 (3) ◽  
pp. 370-371
Author(s):  
Anuj Mahajan ◽  
Scott Kleppe ◽  
Gregory Barnes ◽  
Tammy Fisher ◽  
Joseph Kuhn
Keyword(s):  
Gastric Bypass ◽  
Surgical Management ◽  
Gastric Bypass Patient ◽  
Bypass Patient

scholarly journals Gastric Pouch Mixed Adenoneuroendocrine Carcinoma With a Mixed Adenocarcinoma Component After Roux-en-Y Gastric Bypass

2017 ◽  
Vol 5 (4) ◽  
pp. 232470961774090 ◽  
Author(s):  
Ricardo G. Pastorello ◽  
Mariana Petaccia de Macedo ◽  
Wilson Luiz da Costa Junior ◽  
Maria Dirlei F. S. Begnami
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Gastric Pouch ◽  
Unique Case ◽  
Rare Type ◽  
Mixed Adenoneuroendocrine Carcinoma ◽  
Early Cancer Diagnosis ◽  
Excluded Stomach ◽  
Cell Components ◽  
Adenocarcinoma Component

The Roux-en-Y gastric bypass is one of the most common procedures currently performed for surgical treatment of patients with severe obesity. Gastric cancer after bariatric surgery is not common, with most of them arising in the excluded stomach. Gastric mixed adenoneuroendocrine carcinomas are a rare type of stomach malignancy, composed of both adenocarcinoma and neuroendocrine tumor-cell components, with the latter comprising at least 30% of the whole neoplasm. In this article, we report a unique case of a mixed adenoneuroendocrine carcinoma with a mixed adenocarcinoma (tubular and poorly cohesive) component arising in the gastric pouch of a patient who underwent previous Roux-en-Y gastric bypass for glycemic control. Since stomach cancer is not usual in patients who have formerly undergone bariatric surgery and symptoms tend to be nonspecific, such diagnosis is often rendered at an advanced stage. Full assessment of these patients when presenting such vague symptoms is critical for an early cancer diagnosis.

scholarly journals Phytobezoar: a rare cause of late upper gastrointestinal perforation following gastric bypass surgery

2012 ◽  
Vol 94 (2) ◽  
pp. e85-e87 ◽  
Author(s):  
SJ Sammut ◽  
S Majid ◽  
S Shoab
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Intestinal Perforation ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Exploratory Laparotomy ◽  
Gastrointestinal Perforation ◽  
Direct Closure ◽  
Operative Recovery ◽  
Upper Gastrointestinal

Marginal ulcers are a well described complication following Roux-en-Y gastric bypass. These may be a cause for perforation. We describe a case of upper gastrointestinal perforation 18 months following a laparoscopic Roux-en-Y gastric bypass that appeared to be caused by a food bezoar. The perforation occurred at the site of the jejunojejunal anastomosis and was repaired after an exploratory laparotomy. After extracting the food debris (phytobezoar) through the perforation, direct closure resulted in an uneventful post-operative recovery. To our knowledge, this is the first description of a food bezoar causing an intestinal perforation in such a manor after bariatric surgery. Patients should be educated carefully on what and how to eat after having undergone surgery for superobesity.

P140 LAPAROSCOPIC MODIFIED BELSEY TYPE FUNDOPLICATION FOR REFLUX AFTER ROUX Y GASTRIC BYPASS – A POTENTIAL SAVIOR WHEN THE SAVIOR IS IN TROUBLE!

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Al Saadi Hatem ◽  
Raza Syed ◽  
Sharples Alistair ◽  
Rao Vittal ◽  
Nagammapudur Balaji
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Hiatal Hernia ◽  
Gastric Pouch ◽  
Revisional Bariatric Surgery ◽  
Barium Swallow ◽  
Hiatal Hernia Repair ◽  
Co Morbidity ◽  
Patient Reported

Abstract Background Roux Y Gastric Bypass (RYGB) is the preferred primary bariatric surgical option in patients with preoperative gastro oesophageal reflux disease (GERD). It is also the preferred revisional bariatric surgery after when GERD develops after an alternate primary bariatric surgery. However reflux after RYGB although uncommon can present due to a variety of factors. Management can be challenging. Aim/Hypothesis A modified version of the Belsey IV fundoplication can be done laparoscopically to reconstitute the antireflux barrier in the absence of a Fundal remnant in the gastric pouch after RYGB. Methods We present a single patient experience/case study where there was evidence of recurrent GERD in spite of a successful RYGB in terms of weight loss and comorbidity resolution. A 42 year old female with a BMI > 40 and metabolic co-morbidities and GERD was deemed fit for RYGB. After a technically uneventful RYGB with standard limb lengths ( Roux 120cms and BP limb 70 cms) there was significant weight loss ( > 70% EBWL) and co-morbidity resolution. However her symptoms of GERD persisted. An gastroscopy confimed esophagitis and a barium swallow showed evidence of GERD with a small hiatal hernia and a 3-4 cms Candy cane limb. There was no evidence of a gastrogastric fistula. Revisonal surgery was done which revealed no significant candy cane limb. A small (<2cms) hiatal hernia was found. Complete esophageal mobilization and a hiatal hernia repair was done in a standard fashion. Furthermore the anterior wall of the long gastric pouch was invaginated to obtain an approximate coverage of 200 degrees in a single layer Belsey technique. The procedure was completed laparoscopically. Results The post-operative period was uneventful. Patient reported complete absence of reflux after surgery and remains off PPI in the short term. Temporary dysphagia was noticed in the first few weeks after surgery which improved with expectant treatment. Conclusion A Laparoscopic modified Belsey type fundoplication serves as an effective method to treat GERD after a RYGB if other potential causes of GERD are excluded.

scholarly journals Contemporary Role of Robotics in Bariatric Surgery: Experience of CUF Infante Santo Hospital

2018 ◽  
Author(s):  
Emmelie Reynvoet ◽  
Nelson Silva ◽  
Luís Galindo ◽  
Ricardo Girão ◽  
Paulo Reisinho ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Patient Characteristics ◽  
Gastrojejunal Anastomosis ◽  
Quick Recovery ◽  
Gastric Bypass Patient ◽  
Robotic Gastric Bypass ◽  
Percentage Excess Weight Loss ◽  
Primary Gastric Bypass

INTRODUCTION: The use of robotics in bariatric surgery is increasing worldwide, with the main objective of reducing complications and optimising surgical outcome. This study presents a single centre 1.5-year experience and clinical outcome with robotic gastric bypass. METHODS: A retrospective review was performed of 42 consecutive patients who underwent a robotic gastric bypass. Patient files were analysed to obtain patient characteristics, weight loss results and per- and postoperative morbidity. RESULTS: In 32/42 patients, a primary gastric bypass was performed, the remaining 10 procedures were revision cases. Mean start weight was 111.1 (+/- 20.5) kg, mean start BMI was 39.7 (+/- 5.6) kg/m2. Almost half of the patients presented with pre-existing comorbidities.  After a mean follow-up of 9.1 (+/-5.2) months, mean body mass index was 30.16 (+/-5.3) kg/m2 with a percentage excess weight loss of 66.16 (+/- 43.6)%. There were no conversions, no leaks and no mortality. Two patients presented with minor complications; one infected hematoma and one anastomotic ulcer. Mean length of stay in the hospital was 2.8 (2-5) days. All but one patients were satisfied with the weight loss result. CONCLUSION: The robotic gastric bypass is a safe and reproducible approach to treat morbid obesity. A secure handsewn gastrojejunal anastomosis, quick recovery and better ergonomics are the main advantages of this technique.

Unusual Cause of Acute Abdominal Pain in a Roux-en-Y Gastric Bypass Patient

2020 ◽  
pp. 1-4
Author(s):  
Timothy Koch ◽  
Anand Nath ◽  
Bikram K. Paul ◽  
Mario Golocovsky ◽  
Timothy R. Shope ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Abdominal Pain ◽  
Duodenal Bulb ◽  
Exploratory Laparotomy ◽  
Gastric Bypass Patient ◽  
Oral Ibuprofen ◽  
History Of ◽  
Upper Abdominal ◽  
Contrast Ultrasound ◽  
Bypass Patient

Abdominal pain after Roux-en-Y gastric bypass is an important potential complication. Perforation of an ulcer in the excluded duodenum is a rare occurrence in a patient who has undergone gastric bypass. We present a case of a 61-year-old female with a history of Roux-en-Y gastric bypass, who presented with acute right upper quadrant abdominal pain, which began 1 week after starting treatment with ibuprofen. The evaluation revealed tachycardia, epigastric/right upper abdominal tenderness and leukocytosis. CT abdomen without contrast, ultrasound examination and nuclear medicine scan of the gallbladder were unremarkable. Upper endoscopy revealed an ulcer just distal to her gastrojejunostomy. At exploratory laparotomy, a wellcontained perforation was identified on the anterior duodenal bulb. The perforated ulcer was debrided, the intestine closed with sutures and a drain was left in the abscess cavity. Conventional endoscopic access to bypassed duodenum and stomach is difficult after gastric bypass. In this case, the patient ingested oral ibuprofen and developed both a marginal ulceration as well as an ulceration of the excluded duodenal bulb. The latter finding is consistent with a nonsteroidal anti-inflammatory drug side-effect developing via a hematogenous exposure.

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