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Laparoscopic Reversal of Roux-en-Y Gastric Bypass with Hand-Sewn Gastro-Gastrostomy and Resection of the Alimentary Limb.
Obes Surg
December 2024
Department of Upper Gastrointestinal and Bariatric Surgery, University Hospitals Sussex (St Richard's Hospital), Chichester, UK.
Introduction: Roux-en-Y gastric bypass (RYGB) reversal might be necessary to alleviate refractory surgical or nutritional complications, such as postprandial hypoglycemia, malnutrition, marginal ulceration, malabsorption, chronic diarrhea, nausea and vomiting, gastro-esophageal reflux disease, chronic pain, or excessive weight loss. The surgical technique of RYGB reversal is not standardized; potential strategies include the following: (1) gastro-gastrostomy: hand-sewn technique, linear stapler, circular stapler; (2) handling of the Roux limb: reconnection or resection (if remaining intestinal length ≥ 4 m).
Case Presentation: We demonstrate the surgical technique of a laparoscopic reversal of RYGB with hand-sewn gastro-gastrostomy and resection of the alimentary limb with the aim of improving the patient's quality of life.
Sudden-onset gastrointestinal bleeding in a young adult: diagnostic and therapeutic challenges of a Dieulafoy's lesion in the jejunum.
Surg Case Rep
November 2024
Institute of Surgical Gastroenterology, GI & HPB Oncosurgery and Liver Transplant, Sir Ganga Ram Hospital, New Delhi, India.
Background: A Dieulafoy's lesion in the jejunum is at an uncommon site but may be the cause of massive gastrointestinal bleeding. It is characterized by a large, tortuous submucosal artery that erodes the overlying epithelium and presents diagnostic and therapeutic challenges due to its atypical location and presentation.
Case: A 30-year-old male presented with sudden onset syncope and the passage of 200-300 ml of red blood-mixed stool.
[Application of Bi's intestinal loop binding in treating patients with critical esophagojejunal anastomosis leakage].
Zhonghua Wei Chang Wai Ke Za Zhi
May 2024
Department of Gastroenteropancreas, Shanxi Provincial People's Hospital, Taiyuan 030012, China.
To assess the safety and feasibility of Bi's intestinal loop binding treatment of esophageal jejunal anastomotic leak after total gastrectomy. Bi's Intestinal loop binding are suitable for patients who underwent radical total gastrectomy+Roux-en-Y anastomosis and were confirmed by upper gastrointestinal angiography to have esophageal jejunal anastomotic leakage and whose conservative or endoscopic treatment was ineffective. The operation procedure is as follows: take the original central incision of the upper abdomen, remove the abscess around the anastomoses after ventral incision, and place drainage tube inside the abscess, which is convenient to rinse and drain after operation.
View Article and Find Full Text PDFRapunzel Syndrome: A Case of Trichobezoar with Small Bowel Complications.
Surg J (N Y)
October 2022
Department of Pediatrics, Katuri Medical College, Guntur, Andhra Pradesh, India.
Rapunzel syndrome is characterized by a large trichobezoar in the stomach with a tail extending beyond the pylorus into the small bowel, causing mechanical obstruction of the small bowel. A 7-year-old girl presented to the emergency room with severe epigastric pain. Computed tomography suggested trichobezoar causing jejuno-jejunal intussusceptions, bowel wall thickening, and dilated small bowel loops proximal to the obstruction.
View Article and Find Full Text PDFSmall bowel intussusception due to metastatic renal cell carcinoma.
J Surg Case Rep
August 2022
Department of Surgical Oncology and Department of Gastroenterology, St. Savvas Cancer Hospital, 171 Alexandra's Avenue, 11522 Athens, Greece.
Metastases from renal cell carcinoma (RCC) are rarely located in the small bowel and usually present either with iron deficiency anaemia due to occult bleeding or obstructive symptoms. A 65-year-old man with not known malignancy was admitted to our hospital with symptoms of intermittent bowel obstruction. The abdominal computed tomography (CT) scan depicted a large tumour of the right kidney and obstruction of the small intestine at the level of the proximal jejunum.
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