Guzmán-Esquivel H, Arenas-Padilla JA, Pérez-León NF

Language: Spanish
References: 12
Page: 39-43
PDF size: 688.20 Kb.

ABSTRACT

Introduction: anastomotic leak is a serious complication in bariatric surgery, and in BAGUA bypass it could be underreported, due to its low incidence, which highlights the importance of documenting the case. Clinical case: 38-year-old woman with a history of hypothyroidism, previous cesarean section and cholecystectomy surgeries, diagnosed with grade III obesity (BMI 41.9), underwent gastric bypass of an anastomosis (BAGUA) in a private setting. Thirteen days later she presented abdominal pain, fever and tachycardia; a CT scan revealed an 8 × 8 × 8 cm hematoma. The following day, she underwent laparoscopy which showed partial dehiscence of the gastrojejunoanastomosis, which was treated with evacuation of the hematoma and primary closure. Seven days later, she came to our unit due to persistence of abdominal symptoms, which led to a new laparoscopy with the presence of anastomosis leakage, evacuation of the hematoma and conversion to Roux-en-Y, placement of nasojejunal tube, leaving the hospital seventeen days later. Conclusion: the initial repair was not successful, but conversion to Roux-en-Y bypass and nasojejunal tube feeding proved to be safe and definitive solutions. It is crucial to develop surgical revision protocols for these complex cases.

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