Strangulation of upper jejunum in subsequent pregnancy following gastric bypass surgery

Taiwan J Obstet Gynecol. 2007 Sep;46(3):267-71. doi: 10.1016/S1028-4559(08)60032-7.


Objective: Gastric bypass is a surgical procedure that is popularly used to treat morbid obesity. Herein, we report a woman who had a rare gastrointestinal complication during the subsequent antepartum period following a gastric bypass surgery.

Case report: After a Roux-en-Y gastric bypass surgery, a 32-year-old woman had unrelenting epigastria for one week at 36 weeks' gestation. An emergency cesarean delivery, followed by laparotomy, was performed. A female neonate was delivered with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Strangulation and gangrene of the upper jejunum caused by a fibrous band at the site of the Roux anastomosis were revealed. Segmental resection of the nonviable bowel was performed. The patient experienced a smooth postoperative course.

Conclusion: The awareness of internal hernias and small bowel strangulation should be addressed when unrelenting epigastric pain is present in women after Roux-en-Y gastric bypass surgery, during their first subsequent pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Gangrene / etiology
  • Gastric Bypass / adverse effects*
  • Humans
  • Ischemia / etiology*
  • Jejunum / blood supply*
  • Jejunum / pathology*
  • Obesity / surgery
  • Pregnancy
  • Pregnancy Complications / etiology*