Late gastrointestinal hemorrhage after gastric bypass

Scott C. Braley, Ninh T. Nguyen, Bruce Wolfe

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background: Hemorrhage from the excluded gastric segment or duodenum after gastric bypass is an uncommon late complication and poses both diagnostic and therapeutic difficulties. We describe 4 cases of late gastrointestinal (GI) hemorrhage after gastric bypass. Methods: 4 patients who underwent previous Roux-en-Y gastric bypass (RYGBP) presented for management of severe GI hemorrhage. Their history, diagnostic work-up, management, and surgical pathology are reviewed. Results: In all 4 patients, preoperative diagnostic evaluation including nuclear scintigraphy, endoscopy, and angiography failed to localize the source of bleeding. Intraoperative endoscopy of the gastric remnant and subtotal gastrectomy were performed in all 4 patients. The mean time interval between RYGBP operation and gastrectomy was 15.5 years (range 13-17 years). In 3 of 4 patients, the source of bleeding was documented on pathologic examination of the resected gastric remnant and duodenum. At a mean follow-up of 15 months, none of the patients developed recurrent GI hemorrhage. Conclusion: GI hemorrhage after RYGBP can be a diagnostic and therapeutic dilemma. Intraoperative endoscopy of the excluded stomach and subtotal gastrectomy should be considered when the source of bleeding is not identified by conventional diagnostic techniques.

Original languageEnglish (US)
Pages (from-to)404-407
Number of pages4
JournalObesity Surgery
Volume12
Issue number3
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Gastrointestinal Hemorrhage
Gastric Bypass
Gastrectomy
Hemorrhage
Endoscopy
Gastric Stump
Duodenum
Stomach
Surgical Pathology
Radionuclide Imaging
Angiography
History
Therapeutics

Keywords

  • Bariatric surgery
  • Gastrectomy
  • Gastric bypass
  • Hemorrhage
  • Morbid obesity
  • Ulcer

ASJC Scopus subject areas

  • Surgery

Cite this

Late gastrointestinal hemorrhage after gastric bypass. / Braley, Scott C.; Nguyen, Ninh T.; Wolfe, Bruce.

In: Obesity Surgery, Vol. 12, No. 3, 2002, p. 404-407.

Research output: Contribution to journalArticle

Braley, Scott C. ; Nguyen, Ninh T. ; Wolfe, Bruce. / Late gastrointestinal hemorrhage after gastric bypass. In: Obesity Surgery. 2002 ; Vol. 12, No. 3. pp. 404-407.
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