Uribe Alejandro Flores, Arévalo Jorge Alberto González, Contreras Carlos García, Mendoza Ricardo Tello, Uribe Oscar Armando Flores
General Surgery Department, Christus Muguerza Alta Especialidad Hospital, Monterrey, Nuevo León, México.
General Surgery Department, Christus Muguerza Alta Especialidad Hospital, Monterrey, Nuevo León, México.
Int J Surg Case Rep. 2022 Dec;101:107787. doi: 10.1016/j.ijscr.2022.107787. Epub 2022 Nov 23.
We report a case of late concomitant complications caused by conventional Roux-en-Y gastric bypaas and its managements.
A 62-year-old male presented 27 years after conventional gastric bypass Y-de-Roux (BGYR) with, sudden, moderate intensity abdominal pain, nausea, biliary vomiting and hyporexia. Persistent abdominal pain was constant, so a thoracoabdominal tomography was requested by the surgeon. It confirmed the presence of intestinal intussusception associated with lithiasis and cholecystitis. The patient reported having lost 45 kg since the BGYR. He goes to the operating room for definitive management.
The etiology of post-BGYR intussusception is largely unknown, and multiple hypotheses have been created, such as the iatrogenic stitch created by the suture line in the entero-enteric anastomosis and the most common pattern found is antegrade. The use of contrasted CT as the most reliable diagnostic method.
The importance of taking into account the possible complications existing in bariatric patients and their frequency gives us the opportunity to suspect and detect them in time and in the most cases the management must be surgical.
我们报告一例传统Roux-en-Y胃旁路术引起的晚期并发并发症及其处理情况。
一名62岁男性在接受传统Y型Roux-en-Y胃旁路术（BGYR）27年后出现突发的中度腹痛、恶心、胆汁性呕吐和食欲减退。持续性腹痛持续存在，因此外科医生要求进行胸腹CT检查。检查证实存在与结石和胆囊炎相关的肠套叠。该患者自接受BGYR手术后体重减轻了45公斤。他前往手术室接受确定性治疗。
BGYR术后肠套叠的病因很大程度上尚不清楚，已经提出了多种假说，例如肠肠吻合术中缝线造成的医源性缝线，最常见的类型是顺行性。使用增强CT作为最可靠的诊断方法。
考虑到肥胖症患者可能存在的并发症及其发生率的重要性，使我们有机会及时怀疑并检测到这些并发症，并且在大多数情况下必须进行手术治疗。
