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CASE REPORT
Late postoperative bleeding after Roux-en-Y gastric bypass: management and review of literature
  1. Alisha Gupta1,
  2. Mihir M Shah2,
  3. Sudhir N Kalaskar3 and
  4. Matthew Kroh4
  1. 1 General Internal Medicine and Geriatrics, Northwestern University, Chicago, Illinois, USA
  2. 2 Surgical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA
  3. 3 General Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA
  4. 4 General Surgery, Cleveland Clinic, Cleveland, Ohio, USA
  1. Correspondence to Dr Mihir M Shah, shahmihir_999{at}hotmail.com

Abstract

Gastrointestinal (GI) bleeding is a catastrophic complication of gastric bypass. Bleeding can occur during the early or late phase after the operation. Though bleeding after gastric bypass is infrequent, late bleeding is exceedingly rare. We present two patients with late bleeding following Roux-en-Y gastric bypass (RYGB). The first patient, a 65-year-old woman, presented with life-threatening upper GI bleeding almost 5 years after laparoscopic RYGB. The second patient, a 62-year-old woman, presented with upper GI bleeding after almost 14 years following RYGB. Both, due to an eroding marginal ulcer. We discuss here the management of a rare and catastrophic complication of late GI bleeding and review the various reports in the literature describing the late bleeding as a complication of gastric bypass. Late GI bleeding after RYGB presents a diagnostic and interventional challenge. High index of suspicion and adequate management strategies may lessen morbidity and mortality.

  • GI bleeding
  • obesity (nutrition)
  • gastrointestinal surgery
  • ulcer

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Footnotes

  • Contributors AG: Planning, conduct, reporting, conception and design, analysis and interpretation of data. MMS: Planning, conduct, reporting, conception and design, acquisition of data, analysis and interpretation of data. SNK: Planning, conduct, reporting, conception and design, acquisition of data, analysis and interpretation of data. MK: Planning, conduct, reporting, conception and design, analysis and interpretation of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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