We report a rare but potentially fatal complication of duodenal variceal bleeding in a patient status postsleeve gastrectomy. A 52-year-old woman with a history of sleeve gastrectomy presented with melena. Upper gastrointestinal endoscopy revealed bleeding varices in the duodenum that was clipped. After being referred to our institution for further management, CT scans were re-reviewed and revealed large varices in the fourth/fifth segment of the duodenum and proximal jejunum. The patient was referred to surgery. This case highlighted the potential ectopic variceal bleeding after bariatric surgery and calls for detailed examination and open mind when managing postbariatric gastrointestinal bleeders.
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http://dx.doi.org/10.1016/j.gastha.2023.04.006 | DOI Listing |
Cureus
December 2024
Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR.
Background: Obesity is a growing global health issue, with a prevalence rate of 28.8% in Jordan. Bariatric surgery is the most effective treatment for morbid obesity, yet complications such as postoperative bleeding and leakage remain significant concerns.
View Article and Find Full Text PDFJ Visc Surg
January 2025
Digestive Surgery, UFR Lyon Esthôpital Edouard-Herriot, hospices civils de Lyon, université Lyon 1, Lyon, France; Center spécialisé et intégré de l'obésité, Carmen Laboratory, Team 1, Inserm Unit, 1060 Lyon, France.
IS ESG EFFECTIVE IN THE TREATMENT OF OBESITY AND ASSOCIATEDCOMORBIDITIES?: Endoscopic Sleeve Gastroplasty (ESG) is more effective than lifestyle modifications alone for weight loss and improving obesity-related comorbidities. While it has less effect on weight loss compared to Laparoscopic Sleeve Gastrectomy (LSG) in the short to medium term, it offers similar comorbidities resolution to LSG. IS ESG A SAFE PROCEDURE, AND WHAT ARE ITS RISKS?: The safety profile of ESG is consistently supported in the literature.
View Article and Find Full Text PDFSurg Obes Relat Dis
December 2024
Division of Minimally Invasive Surgery, Department of Surgery, University of California San Diego, San Diego, California.
Background: Robotic-assisted bariatric surgery is growing rapidly. The optimal approach to minimize complications remains unclear.
Objective: Assess robot utilization and compare 30-day outcomes for laparoscopic and robotic primary sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database.
Obesity (Silver Spring)
January 2025
Department of Obstetrics & Gynecology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Objective: The objective of this study was to examine whether obesity without preexisting or gestational comorbidities is associated with postpartum hospital use (PHU).
Methods: We studied 2016 to 2018 birth certificate and discharge data on 178,729 New York City births without International Classification of Diseases, Tenth Revision (ICD-10) codes at delivery for diabetes; hypertension; placental disease; anemia; thyrotoxicosis; bariatric surgery; and pulmonary, cardiac, renal, bleeding, autoimmune, digestive, neuromuscular, mental, or substance-use disorders. We defined PHU as ≥1 readmission or emergency department visit within 30 days of delivery discharge.
Surg Technol Int
December 2024
Department of Gastroenterological Surgery, Clinique Clementville, Montpellier, France.
Introduction: Preventing staple line bleeding (SLB) is still a main issue in bariatric surgery procedures, especially after laparoscopic sleeve gastrectomy (LSG). Staple line reinforcements (SLR), mattress sutures, or titanium clip application did not show any statistical superiority compared to other methods. In this randomized controlled trial, we tested hemostatic powder (HP) in order to assess a possible role in the prevention of active bleeding, hematoma formation, the need for transfusions, and the increased risk for hospitalization.
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