Gastric Remnant Perforation 10 Years After Roux-en-Y Gastric Bypass: A Report of a Rare Case

TL;DR

A rare case of gastric remnant perforation 10 years after gastric bypass surgery is reported, highlighting the need for accurate diagnosis and timely treatment.

Contribution

This paper presents a rare clinical case and emphasizes the importance of considering gastric remnant complications in post-RYGB patients.

Findings

Gastric remnant perforation can occur years after Roux-en-Y gastric bypass.

Diagnostic imaging may mislead, requiring laparoscopic confirmation.

Timely surgical repair leads to successful recovery.

Abstract

Gastric remnant perforation is a rare yet potentially fatal complication following Roux-en-Y gastric bypass (RYGB). The exclusion of this segment from the alimentary tract creates significant diagnostic challenges, often leading to misdiagnosis. We report the case of a 42-year-old woman, 10 years status post RYGB for obesity, presenting with acute generalized abdominal pain. Initial imaging studies suggested ovarian torsion, but diagnostic laparoscopy revealed a perforation of the gastric remnant. Laparoscopic repair was successfully performed, and the patient recovered without complications. This case underscores the importance of maintaining a high index of suspicion for gastric remnant complications in post-RYGB patients, particularly when symptoms mimic alternative intra-abdominal pathologies. Early interdisciplinary collaboration and timely surgical intervention are crucial for optimal outcomes.

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