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Essential bariatric emergencies for the acute care surgeon

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Abstract

Bariatric surgery is the most effective treatment for morbid obesity. Due to the high volume of weight loss procedures worldwide, the general surgeon will undoubtedly encounter bariatric patients in his or her practice. Liberal use of CT scans, upper endoscopy and barium swallow in this patient population is recommended. Some bariatric complications, such as marginal ulceration and dyspepsia, can be effectively treated non-operatively (e.g., proton pump inhibitors, dietary modification). Failure of conservative management is usually an indication for referral to a bariatric surgery specialist for operative re-intervention. More serious complications, such as perforated marginal ulcer, leak, or bowel obstruction, may require immediate surgical intervention. A high index of suspicion must be maintained for these complications despite “negative” radiographic studies, and diagnostic laparoscopy performed when symptoms fail to improve. Laparoscopic-assisted gastric band complications are usually approached with band deflation and referral to a bariatric surgeon. However, if acute slippage that results in gastric strangulation is suspected, the band should be removed immediately. This manuscript provides a high-level overview of all essential bariatric complications that may be encountered by the acute care surgeon.

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Authors and Affiliations

  1. Department of Surgery, St. Luke’s University Health Network, NW2 Administration, 801 Ostrum Street, Bethlehem, PA, USA

    B. Wernick, M. Jansen, S. P. Stawicki & M. El Chaar

  2. Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA

    S. Noria

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Brian Wernick, Matthew Jansen, Sabrena Noria, Stanislaw P. Stawicki and Maher El Chaar declare that they have no conflict of interest.

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Wernick, B., Jansen, M., Noria, S. et al. Essential bariatric emergencies for the acute care surgeon. Eur J Trauma Emerg Surg 42, 571–584 (2016). https://doi.org/10.1007/s00068-015-0621-x

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