Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass

Perforated ulcers of the excluded stomach or duodenum are exceedingly rare in patients who have undergone Roux-en-Y gastric bypass surgery. The diagnosis of perforated ulcer after Roux-en-Y gastric bypass remains challenging as there is often absence of free air or contrast extravasation from the bi...

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Main Authors: Amanda M. Marsh, Ayman Almousa, Thomas Genuit, David Forcione, Karin Blumofe
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2021/6662433
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author Amanda M. Marsh
Ayman Almousa
Thomas Genuit
David Forcione
Karin Blumofe
author_facet Amanda M. Marsh
Ayman Almousa
Thomas Genuit
David Forcione
Karin Blumofe
author_sort Amanda M. Marsh
collection DOAJ
description Perforated ulcers of the excluded stomach or duodenum are exceedingly rare in patients who have undergone Roux-en-Y gastric bypass surgery. The diagnosis of perforated ulcer after Roux-en-Y gastric bypass remains challenging as there is often absence of free air or contrast extravasation from the biliopancreatic limb. We present a patient with signs and symptoms of acute cholecystitis. Laparoscopic cholecystectomy was complicated by postoperative bile leak. EDGE procedure was performed to access the remnant stomach and endoscopic evaluation revealed a perforated ulcer in the posterior duodenal bulb. Although unusual, in patients with bariatric surgery and upper abdominal pain, differential diagnosis including perforated ulcer of the biliopancreatic limb must be considered and early surgical exploration is essential.
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institution Kabale University
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series Case Reports in Surgery
spelling doaj-art-36304880466641ef80a0bbcd37e9accc2025-02-03T01:24:43ZengWileyCase Reports in Surgery2090-69002090-69192021-01-01202110.1155/2021/66624336662433Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric BypassAmanda M. Marsh0Ayman Almousa1Thomas Genuit2David Forcione3Karin Blumofe4Department of General Surgery, Florida Atlantic University Schmidt College of Medicine, Boca Raton, Florida, USADepartment of General Surgery, Florida Atlantic University Schmidt College of Medicine, Boca Raton, Florida, USADepartment of General Surgery, Florida Atlantic University Schmidt College of Medicine, Boca Raton, Florida, USADepartment of General Surgery, Florida Atlantic University Schmidt College of Medicine, Boca Raton, Florida, USADepartment of General Surgery, Florida Atlantic University Schmidt College of Medicine, Boca Raton, Florida, USAPerforated ulcers of the excluded stomach or duodenum are exceedingly rare in patients who have undergone Roux-en-Y gastric bypass surgery. The diagnosis of perforated ulcer after Roux-en-Y gastric bypass remains challenging as there is often absence of free air or contrast extravasation from the biliopancreatic limb. We present a patient with signs and symptoms of acute cholecystitis. Laparoscopic cholecystectomy was complicated by postoperative bile leak. EDGE procedure was performed to access the remnant stomach and endoscopic evaluation revealed a perforated ulcer in the posterior duodenal bulb. Although unusual, in patients with bariatric surgery and upper abdominal pain, differential diagnosis including perforated ulcer of the biliopancreatic limb must be considered and early surgical exploration is essential.http://dx.doi.org/10.1155/2021/6662433
spellingShingle Amanda M. Marsh
Ayman Almousa
Thomas Genuit
David Forcione
Karin Blumofe
Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass
Case Reports in Surgery
title Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass
title_full Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass
title_fullStr Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass
title_full_unstemmed Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass
title_short Bile Leak following Laparoscopic Cholecystectomy due to Perforated Duodenal Ulcer in Patient with Roux-en-Y Gastric Bypass
title_sort bile leak following laparoscopic cholecystectomy due to perforated duodenal ulcer in patient with roux en y gastric bypass
url http://dx.doi.org/10.1155/2021/6662433
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