Seven Cases of Gastric Perforation in Roux-en-Y Gastric Bypass Patients: What Lessons Can We Learn?
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Patients undergoing Roux-en-Y gastric bypass for the resolution of morbid obesity have significant medical sequelae related to their weight. One of the most common comorbid conditions is joint pain requiring the use of non-steroidal anti-inflammatory medications (NSAIDs). In addition to NSAIDs, patients may engage in behaviors such as smoking and alcohol misuse that increase the risk of long-term postoperative complications to include gastric perforation.
Data on 1,690 patients undergoing gastric bypass surgery were collected prospectively and reviewed retrospectively.
We identified seven patients who presented to an emergency room and subsequently required emergent surgical intervention for repair of gastric perforation. Six of the seven cases involved use or abuse of NSAIDs.
Important characteristics were identified including the use of NSAIDs, alcohol use, and non-compliance with routine long-term postoperative follow-up. Identifying those patients at high risk may decrease the incidence of this potentially life-threatening complication.
KeywordsMarginal ulcer (MU) Roux-en-Y gastric bypass (RYGB) Gastrointestinal anastomosis Helicobacter pylori (H. pylori) Proton pump inhibitors (PPI) Bariatric surgery