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Surgery Journals | Surgery Articles | Journal of General Surgery | High Impact Articles | Scient Open Access
Journal of General Surgery


Case Report

Acute Abdominal Pain after Laparoscopic Roux-en-Y Gastric Bypass, What Are We Missing?

Gabriel A. Molina, Jonathan M. Ayala, Ramiro A. Guadalupe

Correspondence Address :

Gabriel A. Molina MD
PGY3 Resident General Surgery
, P.U.C.E, Quito-Ecuador
Tel: +593-998352353

Received on: March 06, 2018, Accepted on: March 21, 2018, Published on: March 28, 2018

Citation: Gabriel A. Molina, Jonathan M. Ayala, Ramiro A. Guadalupe (2018). Acute Abdominal Pain after Laparoscopic Roux-en-Y Gastric Bypass, What Are We Missing?

Copyright: 2018 Gabriel A. Molina, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Unintentional ingestion of foreign bodies like fish bones is a common condition in medical practice. Fortunately, most of the fish bones pass through the gastrointestinal tract without causing any complications. However, intestinal perforations by these sharp  or pointed fish bones can lead to high morbidity and mortality. Accidental ingestion of fish bones after gastric bypass is rarer, mostly due to patient adjustment in how they manage their food and their eating behavior.
Intestinal perforations by foreign bodies should be managed promptly by a surgeon, however preoperative diagnose is usually difficult since most of the clinical symptoms are usually nonspecific and can mimic other surgical conditions, this is particularly important after gastric bypass when serious complications could potentially occur in a misdiagnosis. We report a case of a 30-year-old patient with past medical history of gastric bypass, who visited the emergency room with abdominal pain and tenderness. Even though laboratory exams and images were normal, the pain persisted so an exploratory laparoscopy was performed and it revealed a small bowel perforation at the biliary digestive junction due to a fish bone.
The fish bone was successfully extracted during laparoscopy, and the patient completely recovered.

Keywords: Fish Bone, Intestinal Perforation, Gastric Bypass