Document Detail


Small bowel ischemia after Roux-en-Y gastric bypass complicated by pregnancy: a case report.
MedLine Citation:
PMID:  15869139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Small bowel obstruction is an unusual complication of pregnancy. Its occurrence after Roux-en-Y gastric bypass (RYGB) for morbid obesity complicated by pregnancy is rare. Morbid obesity describes body weight at least 100 lb over the ideal weight, or a body mass index (BMI) > or = 40. Surgery offers the only viable treatment option with long-term weight loss and maintenance. This case report involves a 23-year-old female at 25 weeks gestation with a 1-day history of diffuse abdominal pain and vomiting. She had a RYGB with a 15 cc micropouch 6 months prior to the commencement of this pregnancy. All radiologic investigations were normal. Esophagogastroscopy was performed revealing an ischemic Roux limb of the gastric bypass. At laparotomy, an internal hernia involving the afferent limb was identified at the site of the Roux anastomosis compromising portions of both the afferent and Roux limbs. Nonviable portions of both the afferent and Roux limbs were resected. Gastrointestinal continuity was achieved by fashioning a gastro-gastrostomy and a jejuno-jejunostomy, thus reversing the original gastric bypass procedure. The immediate postoperative period was complicated by fetal demise. With the increase in bariatric surgery, small bowel ischemia after Roux-en-Y gastric bypass will most likely become more prevalent, particularly in women of childbearing age.
Authors:
Anthony Charles; Shirley Domingo; Aaron Goldfadden; Jason Fader; Richard Lampmann; Robert Mazzeo
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  71     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-05-04     Completed Date:  2005-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  231-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, St. Joseph Mercy Hospital, Ann Arbor, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / diagnosis,  etiology
Adult
Anastomosis, Roux-en-Y / adverse effects
Female
Follow-Up Studies
Gastric Bypass / adverse effects*,  methods
Gestational Age
Humans
Intestine, Small / blood supply*,  surgery
Ischemia / diagnosis*,  etiology,  surgery
Laparotomy / methods
Obesity, Morbid / diagnosis,  surgery*
Pregnancy
Pregnancy Complications / diagnosis*,  surgery
Pregnancy Outcome
Risk Assessment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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