Nance Michael E, Shapera Emanuel, Wheeler Andrew A
Internal Medicine, University of Missouri-Columbia, Columbia, USA.
General Surgery, University of Missouri-Columbia, Columbia, USA.
Cureus. 2020 Aug 30;12(8):e10132. doi: 10.7759/cureus.10132.
Roux-en-Y gastric bypass (RYGB) is considered the gold standard for weight loss surgery and is an effective, safe treatment for morbid obesity and associated metabolic derangements. Complications such as small bowel obstruction are rare with a reported incidence of 5%. Obstruction caused by hiatal herniation of the gastric pouch and alimentary limb occurs even less frequently. Prompt recognition and treatment are imperative as delayed intervention may result in significant morbidity. At the time of this manuscript there have only been four reported cases in the literature highlighting a paucity of clinical guidance for the recognition and management of this complication. Here we present a case of acute small bowel obstruction secondary to hiatal herniation of the gastric pouch and proximal Roux limb. Furthermore, we review the literature and discuss the key aspects for the management of this complication.
Roux-en-Y胃旁路术（RYGB）被认为是减肥手术的金标准，是治疗病态肥胖及相关代谢紊乱的一种有效、安全的方法。小肠梗阻等并发症较为罕见，报道的发生率为5%。胃囊和消化道肢体的食管裂孔疝引起的梗阻更为少见。及时识别和治疗至关重要，因为延迟干预可能导致严重的发病率。在撰写本文时，文献中仅报道了4例病例，这突出表明在识别和处理这种并发症方面缺乏临床指导。在此，我们报告一例因胃囊和近端Roux肢体的食管裂孔疝继发急性小肠梗阻的病例。此外，我们回顾了文献并讨论了处理这种并发症的关键要点。
