Descloux Alexandre, Basilicata Giacinto, Nocito Antonio
Department of Surgery, Kantonsspital Baden, Dättwil, 5404 Baden, Switzerland.
Case Rep Surg. 2016;2016:7985795. doi: 10.1155/2016/7985795. Epub 2016 Feb 25.
Introduction. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a common procedure in obesity surgery. The aim of an antecolic approach is to reduce the rate of internal herniation. Our aim is to make bariatric surgeons aware of another possible complication of antecolic LRYGBP. Methods and Results. We present a case report of omental torsion 24 months after antecolic LRYGBP presenting as an acute abdomen, suggesting appendicitis. During diagnostic laparoscopy, omental infarction due to torsion was observed. Resection of the avital omentum was performed. Discussion. Omental torsion after antecolic LRYGBP is a rare complication. When appearing in the early postoperative phase, it may mimic an anastomotic leakage. It may also occur as late complication, presenting with acute abdomen as an appendicitis.
引言。腹腔镜Roux-en-Y胃旁路术（LRYGBP）是肥胖症手术中的常见术式。结肠前入路的目的是降低内疝发生率。我们的目的是让减重外科医生了解结肠前LRYGBP的另一种可能并发症。方法与结果。我们报告一例结肠前LRYGBP术后24个月发生大网膜扭转的病例，表现为急腹症，提示阑尾炎。在诊断性腹腔镜检查中，观察到因扭转导致的大网膜梗死。切除了坏死的大网膜。讨论。结肠前LRYGBP术后大网膜扭转是一种罕见的并发症。在术后早期出现时，可能类似吻合口漏。它也可能作为晚期并发症出现，表现为类似阑尾炎的急腹症。
