Patiño-Araujo Bernarda, Salgado-Báez María E, Villavicencio-Logroño Gabriel P, Ayora-Pérez María J, Zapata-Jaramillo Gabriela S, Salgado-Macías Napoleón
Clínica Bariátrica Dr. Napoleón Salgado, Av. Mariana de Jesús OE7-02 y Nuño de Valderrama, CITIMED, 170509 Quito, Ecuador.
J Surg Case Rep. 2025 Apr 8;2025(4):rjaf202. doi: 10.1093/jscr/rjaf202. eCollection 2025 Apr.
This case report details an unusual instance of small bowel obstruction occurring within 48 h after a successful Roux-en-Y gastric bypass (RYGB) procedure. A 59-year-old woman, who had undergone a revisional RYGB and was discharged 24 h post-surgery, returned to the emergency department with acute epigastric pain and vomiting at the 48-h mark. A contrast computed tomography scan revealed dilated small bowel loops, right pleural effusion, and some free gas. An emergency laparoscopy identified an obstruction at the jejunojejunal anastomosis caused by undigested food, including seeds. The obstructive material was removed, and the anastomosis was reconstructed. Subsequent psychiatric evaluation revealed the patient's abuse of zopiclone, taken at four times the recommended dose. This misuse likely led to anterograde amnesia, resulting in unreported dietary indiscretions. This case underscores the importance of comprehensive medication history and patient education to mitigate risks associated with medication misuse and non-compliance.
本病例报告详细介绍了一例在成功进行Roux-en-Y胃旁路术（RYGB）后48小时内发生的小肠梗阻罕见病例。一名59岁女性接受了RYGB翻修手术，术后24小时出院，在术后48小时因急性上腹部疼痛和呕吐返回急诊科。对比计算机断层扫描显示小肠袢扩张、右侧胸腔积液和一些游离气体。急诊腹腔镜检查发现空肠空肠吻合处因未消化食物（包括种子）导致梗阻。清除了阻塞物，并重建了吻合口。随后的精神科评估显示患者滥用佐匹克隆，服用剂量为推荐剂量的四倍。这种滥用可能导致顺行性遗忘，导致未报告的饮食不当。本病例强调了全面用药史和患者教育对于降低与药物滥用和不依从相关风险的重要性。
