Unique long-term simultaneous complications of conventional Roux-en-Y gastric bypass after 27 years: A case report

Abstract

Introduction: We report a case of late concomitant complications caused by conventional Roux-en-Y gastric bypaas and its managements.

Presentation of case: A 62-year-old male presented 27 years after conventional gastric bypass Y-de-Roux (BGYR) with, sudden, moderate intensity abdominal pain, nausea, biliary vomiting and hyporexia. Persistent abdominal pain was constant, so a thoracoabdominal tomography was requested by the surgeon. It confirmed the presence of intestinal intussusception associated with lithiasis and cholecystitis. The patient reported having lost 45 kg since the BGYR. He goes to the operating room for definitive management.

Discussion: The etiology of post-BGYR intussusception is largely unknown, and multiple hypotheses have been created, such as the iatrogenic stitch created by the suture line in the entero-enteric anastomosis and the most common pattern found is antegrade. The use of contrasted CT as the most reliable diagnostic method.

Conclusion: The importance of taking into account the possible complications existing in bariatric patients and their frequency gives us the opportunity to suspect and detect them in time and in the most cases the management must be surgical.

Keywords: Bypass; Cholecystitis; Complications; Intussusception; Y-de-Roux.