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CASE REPORT   

Chirurgia 2020 December;33(6):341-3

DOI: 10.23736/S0394-9508.20.05078-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

A rare complication of single anastomosis gastric bypass surgery: perforated marginal ulcer

Fahed MEREI 1, Ronit WITZTUM 2, Ibrahim ABU SHAKRA 1, Amitai BICKEL 1, 3, Kamal KHATIB 1, Samer GANAM 1, Maxim BEZ 1, Doron FISCHER 4, Eli KAKIASHVILI 1

1 Department of Surgery A, Galilee Medical Center, Nahariya, Israel; 2 Department of Surgery B, Carmel Medical Center, Haifa, Israel; 3 Faculty of Medicine in the Galilee, Bar-Ilan University, Safad, Israel; 4 Department of Radiology, Galilee Medical Center, Nahariya, Israel



The single anastomosis gastric bypass (SAGB), also known as the mini gastric bypass, is a modification of the loop gastric bypass. The SAGB is technically easier to perform than a Roux-en-Y gastric bypass because it requires only one anastomosis. Marginal ulcer disease is a common complication of gastric bypass surgery, yet perforation of the ulcer is rare. We present a 46-year-old man who presented with chest and upper abdominal pain one year after undergoing SAGB. CT scans of the abdomen and pelvis demonstrated a number of small bowel loops with a thickened wall in the left abdomen, epigastric free abdominal air of a medium-large amount and a small amount of fluid between the intestinal loops and in the pelvis. An urgent exploratory laparoscopy revealed a perforation of a marginal ulcer. Recovery was uneventful. Our patient did not have any of the known risk factors for a marginal ulcer, nor did he have any ulcer specific symptoms prior to his admission. This case demonstrates the possible occurrence of a perforated ulcer following gastric bypass surgery, even among patients without risk factors.


KEY WORDS: Bariatric surgery; Peptic ulcer; Gastric bypass

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