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A case report of late perforation at the site of jejuno-jejunal anastomosis after laparoscopic Roux-en-Y gastric bypass surgery

Authors :
Sarah Al Ben Ali
Khalifah Alyatama
Abdulrahman Al Kandari
Abdulwahab Al Kandari
Sarah Al Hendi
Mohammad Qasem
Source :
International Journal of Surgery Open. 29:20-23
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

Introduction Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed weight-loss surgeries worldwide. Its common complications include bowel obstruction, anastomotic strictures, postoperative leak, dumping syndrome, nutritional complications, and venous thromboembolic events. Presentation of case This report presents a case of perforation at the jejuno-jejunal (j-j) anastomosis, an extremely rare complication after laparoscopic RYGB surgery (LRYGBS), with an incidence reported to be under 1% in the literature. Potential causes noted from previous reports include distal obstruction, abscess formation, patient comorbidities, technical factors, and microbiological factors. A morbidly obese female patient underwent LRYGBS with an uneventful recovery. The patient presented 15 weeks postoperatively with a 2-day history of acute abdominal pain, vomiting, constipation, and peritoneal signs. Discussion Following clinical and radiological evaluation, the patient underwent an exploratory laparoscopy for the diagnosis and treatment of complications. In this case, laparoscopy was shifted to the open technique due to technical difficulties. A 1.5-cm perforation was identified at the site of the anastomosis and was repaired with absorbable sutures and a graham patch. The patient recovered uneventfully. Conclusion Prompt recognition of symptoms and early intervention may reduce overall morbidity and mortality in similar cases. This report describes a case of a late perforation at the site of j-j anastomosis in an obese female. We also discuss the incidence, presentation, management, outcome, and possible causes of such complications.

Details

ISSN :
24058572
Volume :
29
Database :
OpenAIRE
Journal :
International Journal of Surgery Open
Accession number :
edsair.doi...........7ba91c34a75870bfefcfe3dff8ab1872
Full Text :
https://doi.org/10.1016/j.ijso.2020.11.014