Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass

Perforated ulcers of the excluded stomach or duodenum are exceedingly rare in patients who have undergone Roux-en-Y gastric bypass surgery. The diagnosis of perforated ulcer after Roux-en-Y gastric bypass remains challenging as there is often absence of free air or contrast extravasation from the bi...

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Published in:Case reports in surgery 2021-08, Vol.2021, p.1-4
Main Authors: Marsh, Amanda M., Almousa, Ayman, Genuit, Thomas, Forcione, David, Blumofe, Karin
Format: Article
Language:English
Subjects:
Abdomen
Bile
Case Report
Case reports
Cholecystectomy
Cholecystitis
Diagnosis
Differential diagnosis
Duodenum
Endoscopy
Extravasation
Gallbladder
Gallbladder diseases
Gallstones
Gastric bypass
Gastrointestinal surgery
Inflammation
Laparoscopic surgery
Laparoscopy
Nonsteroidal anti-inflammatory drugs
Pain
Patients
Signs and symptoms
Small intestine
Stomach
Surgery
Ulcers
Ultrasonic imaging
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Almousa, Ayman
Genuit, Thomas
Forcione, David
Blumofe, Karin
description Perforated ulcers of the excluded stomach or duodenum are exceedingly rare in patients who have undergone Roux-en-Y gastric bypass surgery. The diagnosis of perforated ulcer after Roux-en-Y gastric bypass remains challenging as there is often absence of free air or contrast extravasation from the biliopancreatic limb. We present a patient with signs and symptoms of acute cholecystitis. Laparoscopic cholecystectomy was complicated by postoperative bile leak. EDGE procedure was performed to access the remnant stomach and endoscopic evaluation revealed a perforated ulcer in the posterior duodenal bulb. Although unusual, in patients with bariatric surgery and upper abdominal pain, differential diagnosis including perforated ulcer of the biliopancreatic limb must be considered and early surgical exploration is essential.
doi_str_mv 10.1155/2021/6662433
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subjects Abdomen
Bile
Case Report
Case reports
Cholecystectomy
Cholecystitis
Diagnosis
Differential diagnosis
Duodenum
Endoscopy
Extravasation
Gallbladder
Gallbladder diseases
Gallstones
Gastric bypass
Gastrointestinal surgery
Inflammation
Laparoscopic surgery
Laparoscopy
Nonsteroidal anti-inflammatory drugs
Pain
Patients
Signs and symptoms
Small intestine
Stomach
Surgery
Ulcers
Ultrasonic imaging
title Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass
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