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Roux-en-Y胃旁路术后两年出现延迟性大出血。

Delayed massive bleeding two years after Roux-en-Y gastric bypass.

作者信息

Coblijn Usha K, Lagarde Sjoerd M, Tuynman Jurriaan B, van Meyel Juup J M, van Wagensveld Bart A

机构信息

Department of Surgery, St. Lucas Andreas Hospital, Amsterdam, The Netherlands.

出版信息

JSLS. 2013 Jul-Sep;17(3):476-80. doi: 10.4293/108680813x13693422518470.

DOI:10.4293/108680813x13693422518470
PMID:24018091
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3771773/
Abstract

INTRODUCTION

Delayed massive bleeding from an ischemic ulcer is a complication after Roux-en-Y gastric bypass (RYGB). Ischemic ulcers that present with massive bleeding are rare and challenging for the gastroenterologist as well as the bariatric surgeon.

CASE DESCRIPTION

This report reviews the case of a 63-year-old man who underwent an uncomplicated laparoscopic RYGB for morbid obesity and experienced two episodes of massive hemorrhage after the procedure, almost 1 year apart.

CONCLUSION

To our knowledge, there are only a few such specific cases reported. Here, we describe the treatment and outcome for such a case and present a review of the literature.

摘要

引言

缺血性溃疡导致的延迟性大出血是Roux-en-Y胃旁路术（RYGB）后的一种并发症。出现大出血的缺血性溃疡较为罕见，对胃肠病学家和减肥外科医生来说都是一项挑战。

病例描述

本报告回顾了一名63岁男性的病例，该患者因病态肥胖接受了无并发症的腹腔镜RYGB手术，并在术后经历了两次大出血事件，两次事件间隔约1年。

结论

据我们所知，仅有少数此类特殊病例被报道。在此，我们描述了该病例的治疗方法及结果，并对相关文献进行了综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc61/3771773/3437503ed478/jls0031331310001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc61/3771773/3437503ed478/jls0031331310001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc61/3771773/3437503ed478/jls0031331310001.jpg

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本文引用的文献

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Incidence of perforated gastrojejunal anastomotic ulcers after laparoscopic gastric bypass for morbid obesity and role of laparoscopy in their management.腹腔镜胃旁路术治疗病态肥胖后胃空肠吻合口溃疡穿孔的发生率及腹腔镜在其治疗中的作用。
Surg Obes Relat Dis. 2012 Jul-Aug;8(4):423-8. doi: 10.1016/j.soard.2011.06.008. Epub 2011 Jun 24.
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Late marginal ulcers after gastric bypass for morbid obesity. Clinical and endoscopic findings and response to treatment.胃旁路术后迟发性边缘溃疡。临床和内镜表现及治疗反应。
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Laparoscopic gastrojejunostomy revision: a novel approach to intractable marginal ulcer management.
胃旁路术后胃残端出口梗阻的内镜治疗：一例报告
World J Gastrointest Endosc. 2020 Sep 16;12(9):297-303. doi: 10.4253/wjge.v12.i9.297.
腹腔镜胃空肠吻合术修复：一种治疗顽固性边缘溃疡的新方法。
Surg Obes Relat Dis. 2010 Sep-Oct;6(5):557-8. doi: 10.1016/j.soard.2010.07.003. Epub 2010 Jul 22.
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Early marginal ulcer following Roux-en-Y gastric bypass under proton pump inhibitor treatment: prospective multicentric study.质子泵抑制剂治疗下Roux-en-Y胃旁路术后早期边缘溃疡：前瞻性多中心研究
Arq Gastroenterol. 2010 Apr-Jun;47(2):130-4. doi: 10.1590/s0004-28032010000200003.
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Association between clinical manifestations of complicated and uncomplicated peptic ulcer and visceral sensory dysfunction.复杂性与非复杂性消化性溃疡的临床表现与内脏感觉功能障碍之间的关联
J Gastroenterol Hepatol. 2010 Jun;25(6):1162-9. doi: 10.1111/j.1440-1746.2010.06269.x.
6
Can a short course of prophylactic low-dose proton pump inhibitor therapy prevent stomal ulceration after laparoscopic Roux-en-Y gastric bypass?腹腔镜 Roux-en-Y 胃旁路术后短期预防性低剂量质子泵抑制剂治疗能否预防吻合口溃疡？
Obes Surg. 2010 May;20(5):595-9. doi: 10.1007/s11695-009-0062-x. Epub 2010 Jan 8.
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Surgery for obesity.肥胖症手术
Cochrane Database Syst Rev. 2009 Apr 15(2):CD003641. doi: 10.1002/14651858.CD003641.pub3.
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Revisional operations for marginal ulcer after Roux-en-Y gastric bypass.Roux-en-Y胃旁路术后边缘性溃疡的修复手术
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