Hospital: COMPLEJO HOSPITALARIO DE TOLEDO.
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Aut@r o Autores: A. Rodríguez-Sánchez, M.M. Merideno García, L.M. Cruz Hernández, M.J. Lucena González, P.A. Barón Ródiz, P. Sánchez-Camacho González-Carrato.,
Presentación:
A 32-year-old woman who recently underwent a Roux-en-Y gastric bypass presents an intense abdominal pain. An urgent abdominopelvic computed tomography (CT) is required to discard acute intraabdominal complications. The main finding is a hyperdense laminar wall point adjacent to the anastomotic union of the biliopancreatic limb. It increases in the later phase, which highly suggests active bleeding. An increased bowel diameter, wall thickness and hyperdense hematic content of the biliopancreatic limb are also observed. Furthermore, pancreatic parenchyma appears with increased size, locoregional inflammatory changes and peripancreatic, perihepatic, perisplenic and perirenal liquid, compatible with secondary acute pancreatitis.
Discusión:
Bariatric surgery for obesity is considered when other treatments have failed. Numerous complications of this surgery are known and require recognition to be appropriately treated. Early gastrointestinal complications of gastric bypass surgery include, among other things: anastomotic leak (usually at the gastrojejunal anastomosis), acute ischemia and anastomotic active bleeding, as it was in this case. The main finding is a contrast blush within the bowel lumen, adjacent to the anastomosis, which increases in delayed-phases of the study. Abdominal pain and hemoglobin decrease also corroborated it.
Conclusión:
Bariatric surgery for obesity is considered when other treatments have failed. Numerous complications of this surgery are known and require recognition to be appropriately treated. Early gastrointestinal complications of gastric bypass surgery include, among other things: anastomotic leak (usually at the gastrojejunal anastomosis), acute ischemia and anastomotic active bleeding, as it was in this case. The main finding is a contrast blush within the bowel lumen, adjacent to the anastomosis, which increases in delayed-phases of the study. Abdominal pain and hemoglobin decrease also corroborated it.
Bibliografía:
– Levine MS, Carucci LR. Imaging of Bariatric Surgery: Normal Anatomy and Postoperative Complications. Radiology 2014, 270(2): 327–41. – Yu J, Turner MA, Cho S-R, Fulcher AS, DeMaria EJ, Kellum JM, et al. Normal Anatomy and Complications after Gastric Byp