Gonzalez-Pezzat Iliana, Soto-Perez-de-Celis Enrique, Pantoja-Millan Juan Pablo
Hospital Angeles del Pedregal, Camino a Santa Teresa 1055. Col Heroes de Padierna, CP 10700, Mexico, Distrito Federal, Mexico.
Obes Surg. 2009 May;19(5):661-3. doi: 10.1007/s11695-009-9831-9. Epub 2009 Mar 24.
Late complications involving the site of the jejunojejunal (J-J) anastomosis are uncommon after laparoscopic Roux-en-Y gastric bypass. We present a case of a perforation at the J-J anastomosis complicated by the formation of an abscess 6 months after surgery. Following clinical and radiological evaluation, the patient underwent an exploratory laparoscopy which had to be converted to an open technique because of technical difficulties. The abscess was drained, the anastomosis was resected, and a new anastomosis was undertaken. When the surgical specimen was inspected, a perforation was found at the site of the previous J-J anastomosis. The patient had an uneventful recovery. To our knowledge, this is the first report of the formation of an abscess due to a perforation at the site of the J-J anastomosis after laparoscopic Roux-en-Y gastric bypass surgery. This complication, although rare, should be taken into account in patients with abdominal pain and systemic inflammatory response syndrome after bariatric surgery.
腹腔镜Roux-en-Y胃旁路术后，空肠空肠（J-J）吻合部位出现晚期并发症并不常见。我们报告一例患者，术后6个月J-J吻合口穿孔并形成脓肿。经过临床和影像学评估后，患者接受了探查性腹腔镜检查，但由于技术困难，不得不转为开放手术。排出脓肿，切除吻合口，并进行了新的吻合。检查手术标本时，发现原J-J吻合部位有穿孔。患者恢复顺利。据我们所知，这是腹腔镜Roux-en-Y胃旁路手术后首例因J-J吻合口穿孔形成脓肿的报告。这种并发症虽然罕见，但在减肥手术后出现腹痛和全身炎症反应综合征的患者中应予以考虑。
