Perforated Ischemic Ulcer at the Jejuno-Jejunal Anastomosis 9 Years Post-laparoscopic Roux-en-Y Gastric Bypass—a Case Report

• Published in: Obesity surgery 2024-03, Vol.34 (3), p.1045-1048
• Main Authors: Elhardello, Osama A., Athamnah, Mohammad N., ElSeify, Gaber H.
• Format: Article
• Language: English
• Subjects: Abdomen; Abscesses; Anastomosis, Roux-en-Y - adverse effects; Antibiotics; Brief Communication; Case reports; Female; Gastric Bypass - adverse effects; Gastric Bypass - methods; Gastrointestinal surgery; Humans; Ischemia; Ischemia - etiology; Ischemia - surgery; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity, Morbid - surgery; Patients; Peritonitis; Surgery; Surgical anastomosis; Ulcer - etiology; Ulcer - surgery; Ulcers; Vascular Diseases - etiology
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-024-07088-6

Background Obesity is a common disease among Kuwaitis. Multiple types of bariatric procedures are offered in Kuwait. R-Y gastric bypass is among the common surgeries performed. Early and late complications must be recognized as early as possible to avoid undesirable consequences. Case Presentation Here, we present a case of a 48-year-old lady presented as acute abdominal pain and diagnosed as Jejuno-Jejunal anastomosis site ulceration / perforation taking place several years from surgery. Discussion Etiology of late perforation can be attributed to ischemia. Computerized tomography (C.T.) scan is the gold standard for diagnosis. Management can be laparoscopic or open surgery depending on surgeon expertise. We performed a laparoscopic resection for the extended perforated jejunal recess and that was enough to resolve our patient’s problem.