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2022, Number 1-2

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Rev Mex Cir Endoscop 2022; 23 (1-2)

Unusual causes of intestinal obstruction in the bariatric population: presentation of three cases

Pereyra-Talamantes A, Flores-Martín JE, Gallaga-Rojas MA, Vergara-Tamayo E, Pérez-Morales Ó

Language: Spanish
References: 26
Page: 31-36
PDF size: 241.48 Kb.


ABSTRACT

Introduction: the most common cause of intestinal obstruction after Roux-en-Y gastric bypass (RYGB) is internal herniation and can be resolved by laparoscopic approach. The objective of this paper is to present three unusual causes of intestinal obstruction in bariatric patients that can be resolved by a minimally invasive approach. Report of cases: The first case presents a 31-year-old patient with a history of Roux-en-Y gastric bypass 3 years previously who presented with an occlusive syndrome. An intussusception was diagnosed and successfully managed with laparoscopy. The second case is a 37-year-old patient who had a gastric balloon placed 1 year prior to admission, who did not attend withdrawal at 6 months, goes to the hospital with an occlusive picture, diagnosing distal impaction of the balloon, which was successfully extracted laparoscopic route. Last case, a 39-year-old patient with a history of Roux-en-Y gastric bypass 9 years prior to admission with occlusive syndrome. Laparoscopy revealed an 8 cm impacted phytobezoar in the terminal ileum. It was manually removed using a 5 cm disposable retractor through the umbilicus. Results: two cases were successfully resolved laparoscopically and the third was extracted extracorporeally, but with a laparoscopic approach. No patient presented early or late complications. Conclusions: the causes of intestinal obstruction in this series of bariatric cases are unusual and all could be resolved by minimal invasion with no mortality to report.


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