Wang Chen-Bin, Hsieh Ching-Chuan, Chen Chun-Hung, Lin Yu-Hsiang, Lee Chung-Yuan, Tseng Chih-Jen
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chia Yi, Taiwan.
Taiwan J Obstet Gynecol. 2007 Sep;46(3):267-71. doi: 10.1016/S1028-4559(08)60032-7.
Gastric bypass is a surgical procedure that is popularly used to treat morbid obesity. Herein, we report a woman who had a rare gastrointestinal complication during the subsequent antepartum period following a gastric bypass surgery.
After a Roux-en-Y gastric bypass surgery, a 32-year-old woman had unrelenting epigastria for one week at 36 weeks' gestation. An emergency cesarean delivery, followed by laparotomy, was performed. A female neonate was delivered with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Strangulation and gangrene of the upper jejunum caused by a fibrous band at the site of the Roux anastomosis were revealed. Segmental resection of the nonviable bowel was performed. The patient experienced a smooth postoperative course.
The awareness of internal hernias and small bowel strangulation should be addressed when unrelenting epigastric pain is present in women after Roux-en-Y gastric bypass surgery, during their first subsequent pregnancy.
胃旁路手术是一种常用于治疗病态肥胖的外科手术。在此，我们报告一名女性，她在胃旁路手术后的后续孕期出现了罕见的胃肠道并发症。
一名32岁女性在接受Roux-en-Y胃旁路手术后，妊娠36周时上腹部持续疼痛一周。进行了紧急剖宫产，随后进行了剖腹手术。一名女婴出生，1分钟和5分钟时的阿氏评分分别为8分和9分。发现Roux吻合部位的纤维带导致空肠上段绞窄和坏疽。对无活力的肠段进行了节段性切除。患者术后恢复顺利。
当接受Roux-en-Y胃旁路手术的女性在首次后续妊娠期间出现持续上腹部疼痛时，应考虑内疝和小肠绞窄的可能性。
