Marginal ulcer after Roux-en-Y gastric bypass:one case report with a literature review
Marginal ulcer is a common complication after Roux-en-Y gastric bypass and its improper management may cause serious consequences,including perforation,hemorrhage and stenosis.This report described one female case of anastomotic marginal ulcer after Roux-en-Y gastric bypass.She initially underwent laparoscopic Roux-en-Y gastric bypass in April 2011 for metabolic syndrome.In September 2017,there was an onset of recurrent abdominal pain with altered stool consistency.After thorough examinations,marginal ulcer was diagnosed due probably to an enlargement of gastric pouch.Consequently,in October 2019,laparoscopic sleeve gastrectomy was performed along with partial small bowel resection.Despite regular postoperative dosing of antacids,recurrent abdominal pain,nausea and vomiting persisted.Follow-up gastroscopy revealed non-healing of anastomotic marginal ulcer.In June 2022,after completing thorough preoperative preparation,laparoscopic partial gastric-gastrointestinal anastomosis,nutritional branch jejunostomy and gastric bypass revision were performed.Postoperative symptoms improved markedly.Follow-up gastroscopy at Month 8 showed no sign of ulceration.This case illustrated the challenge of managing marginal ulcers since two revision operations over nearly 5 years were required for curing.Focusing upon the relevant literature on marginal ulcers after Roux-en-Y gastric bypass,this review summarized risk factors,treatments and prevention strategies to provide references for bariatric and metabolic surgeons.
Roux-en-Y gastric bypassBariatric and metabolic surgeryComplicationsMarginal ulcerRevision surgery
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