Bariatric surgery complications
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</parsererror> Weight Loss Surgery Complications
1. Background
2. Presentation
3. Complications - early and late
4. Workup
1. Background - Rou-en-Y - malabsorptive and restrictive physiology
- Gastric Sleeve - restrictive
- Biliopancreatic diversion
- Vertical banded gastroplaty - now historical as replaced by LAP band
2. Presentation
- abdominal pain, food intolerance
- sepsis, abnormal VS
3. Complications
a. Early
VTE, PNA, UTI, SBO, etc
Roux-Limb Obstruction
- NV, abd pain
- causes acute Gastric dilation
- surgical emergency
- IR decompression possible
Anastamotic Leak
- abdominal exam often non-acute due to habitus
Intra-abdominal bleeding
- may bleed into GI tract and only visualized on endoscopy
b. Late
Anastomotic Leak or Stricture
- progressive inability to tolerate PO
- abdominal pain
- solids first then liquids
- needs UGI then likely endoscopy
Marginal Ulcer
- epigastric pain and dyspepsia
- upper endoscopy
- manage with acid suppression
Internal hernia
- obstructive or nonobstructive
- crampy intermitten abd pain radiating to back
- can have nl abd exam
- may strangulate herniated bowel
- w/u CT AP and UGI
- CT findings swirl sign, intussuscepted bowel
- needs surgery early
Nurtitional Complications
- consider pts immunosuppressed due to malnourishment
- Anemia, neuropathy, fractures, hypercalcemia
- Wernickes encephalopathy
4. Workup
CT AP - use PO & IV contrast
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