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Review
. 2011 Jun;201(6):819-27.
doi: 10.1016/j.amjsurg.2010.05.007. Epub 2011 Feb 18.

Abdominal pain after gastric bypass: suspects and solutions

Alexander J Greenstein  1 , Robert W O'Rourke
Affiliations
Review

Abdominal pain after gastric bypass: suspects and solutions

Alexander J Greenstein et al. Am J Surg. 2011 Jun.

Abstract

Background: Gastric bypass remains the mainstay of surgical therapy for obesity. Abdominal pain after gastric bypass is common and accounts for up to half of all postoperative complaints and emergency room visits. This article reviews the most important causes of abdominal pain specific to gastric bypass and discusses management considerations.

Methods: The current surgical literature was reviewed using PubMed, with a focus on abdominal pain after gastric bypass and the known pathologies that underlie its pathogenesis.

Results: The etiologies of abdominal pain after gastric bypass are diverse. A thorough understanding of their pathogenesis impacts favorably on clinical outcomes.

Conclusions: The differential diagnosis for abdominal pain after gastric bypass is large and includes benign and life-threatening entities. Its diverse causes require a broad evaluation that should be directed by history and clinical presentation. In the absence of a clear diagnosis, the threshold for surgical exploration in patients with abdominal pain after gastric bypass should be low.

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Figures

Figure 1
Figure 1. Gastric bypass internal hernia anatomy
An antecolic Roux limb configuration is shown, with arrows indicating mesenteric and Petersen’s hernias.
Figure 2
Figure 2. Mesenteric swirl sign
arrow indicates swirl sign
See this image and copyright information in PMC

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