Duodenal Ulceration Erosion Into the Common Bile Duct Status Post-Roux-en-Y Gastric Bypass: A Case Report

TL;DR

A rare case of a duodenal ulcer eroding into the common bile duct is reported in a patient who had gastric bypass surgery 19 years earlier.

Contribution

This case report highlights an uncommon complication of Roux-en-Y gastric bypass surgery involving bile duct erosion without fistula formation.

Findings

A 69-year-old female developed an ulcer perforation 19 years after Roux-en-Y gastric bypass.

The ulcer eroded into the common bile duct without forming a fistula, a rare post-surgery complication.

Abstract

Peptic ulcer disease (PUD) affects approximately four million people worldwide. The most common etiologies of PUD are Helicobacter pylori (H. pylori) infections, chronic nonsteroidal anti-inflammatory drug (NSAID) use, and smoking. A rare cause of ulcer formation is documented in patients following Roux-en-Y gastric bypass (RYGB) procedures. Delayed treatment of these ulcers can further lead to ulcer perforation, erosion of the gastroduodenal artery (GDA), and fistula formation between the biliary structures and the gastrointestinal tract. Herein, we discuss the case of a 69-year-old female with an ulcer perforation 19 years after RYGB, resulting in an atypical ulcer erosion of the common bile duct without fistula formation.

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