CASE REPORT   

Chirurgia 2023 February;36(1):38-42

DOI: 10.23736/S0394-9508.22.05417-1

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Life-threatening bleeding due to left gastric artery erosion as a late complication after Roux-en-Y gastric bypass

Manrica FABBI ¹ ✉, Gianluca MARCOCCI ², Andrea MORLACCHI ¹, Farhad NEHCHIRI ¹, Monica LUCINI ¹, Giovanni LENNA ¹, Pietro F. BAGNOLI ¹

¹ Department of General and Emergency Surgery, Istituto Clinico Città Studi, Milan, Italy; ² Department of General Surgery, Vita-Salute San Raffaele University, Milan, Italy

Surgical treatment is considered to be the therapy of choice for patients affected by severe obesity. In the Roux-en-Y-gastric bypass, one of the most commonly bariatric surgeries performed, the post operative gastrointestinal bleeding could become a very serious complication. Bleeding can occur during the early or late phase after the operation. Though early bleeding is infrequent, late bleeding is exceedingly rare and considered a real challenge regarding diagnose, treatment and management. In this article we present a rare case of a young patient with life-threatening upper gastrointestinal bleeding due to erosion of left gastric artery, occurred almost one year after Roux-en-Y-gastric bypass. We discuss the path to diagnosis and the successful treatment performed of this rare and severe complication and review the limited data present in the literature.

KEY WORDS: Hemorrhage; Gastrointestinal hemorrhage; Postoperative complications; Roux-en-Y anastomosis; Gastric bypass