Perforated marginal ulceration in the setting of single anastomosis duodeno-ileal switch (SADI-S) with conversion to Roux-en-Y gastric bypass and literature review.

The single anastomosis duodenal-ileal switch (SADI-S) has become a safe alternative to Roux-en-Y gastric bypass (RYGB) in the treatment for morbid obesity. A known complication after bariatric surgery is the development of marginal ulceration. The current literature demonstrates an overwhelmingly low incidence of ulceration in patients who underwent SADI-S. The management and prevention is an ongoing subject of debate with no clear algorithm. The conversation of SADI-S to RYGB has been accomplished; however, this procedure has not been previously reported for marginal ulceration.