Yoon Joshua J, Nguyen Thuyduong, Raquet Brandon, Pai Chetan
Internal Medicine, Edward Via College of Osteopathic Medicine, Blacksburg, USA.
Gastroenterology, Mary Washington Healthcare, Fredericksburg, USA.
Cureus. 2025 Jun 2;17(6):e85245. doi: 10.7759/cureus.85245. eCollection 2025 Jun.
The Roux-en-Y gastric bypass (RYGB) is a commonly performed bariatric surgery option for individuals with severe obesity. Although gastrointestinal (GI) bleeds are a well-recognized complication of RYGB, it is uncommon in the late postoperative period as the surgical sites heal. It can be challenging to diagnose and manage these GI bleeds due to their isolated location and, consequently, difficult accessibility via traditional endoscopy. Various approaches have been described for the management of this complication with different treatment options, and treatment can vary based on patient risk factors and presentation. We report a case of a patient with bleeding in the gastric remnant 18 years after bypass surgery. Traditional endoscopy and other imaging options were attempted before surgical intervention, with laparoscopy and intraoperative endoscopy being warranted. The patient was discharged in stable condition after spontaneous hemostasis following a complicated hospital course.
Roux-en-Y胃旁路术（RYGB）是一种常用于重度肥胖患者的减肥手术选择。虽然胃肠道（GI）出血是RYGB公认的并发症，但在术后晚期手术部位愈合时并不常见。由于这些胃肠道出血部位孤立，因此通过传统内镜检查难以到达，诊断和处理这些出血具有挑战性。针对这种并发症的处理已经描述了各种方法，有不同的治疗选择，治疗方法可根据患者的风险因素和表现而有所不同。我们报告一例患者在旁路手术后18年胃残端出血的病例。在进行手术干预之前尝试了传统内镜检查和其他影像学检查，最终需要进行腹腔镜检查和术中内镜检查。经过复杂的住院治疗过程后，患者在自发止血后病情稳定出院。
