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. 2016:23:112-5.
doi: 10.1016/j.ijscr.2016.04.008. Epub 2016 Apr 22.

Gastric bezoar after Roux-en-Y gastric bypass for morbid obesity: A case report

Ismail Ertugrul  1 , Ali Tardum Tardu  2 , Kerem Tolan  3 , Cuneyt Kayaalp  4 , Servet Karagul  5 , Serdar Kirmizi  6
Affiliations

Gastric bezoar after Roux-en-Y gastric bypass for morbid obesity: A case report

Ismail Ertugrul et al. Int J Surg Case Rep. 2016.

Abstract

Introduction: We aimed to present a patient with gastric pouch bezoar after having a bariatric surgery.

Presentation of case: Sixty-three years old morbid obese female had a laparoscopic Roux-en-Y gastric bypass surgery 14 months ago. She has lost 88% of her excess body mass index; but started to suffer from nausea, abdominal distention and vomiting lately, especially for the last two months. The initial evaluation by endoscopy, computed tomography (CT) and an upper gastrointestinal contrast series overlooked the pathology in the gastric pouch and did not display any abnormality. However, a second endoscopy revealed a 5cm in diameter phytobezoar in the gastric pouch which was later endoscopically removed. After the bezoar removal, her complaints relieved completely.

Discussion: The gastric bezoars may be confused with the other pathologies because of the dyspeptic complaints of these patients. The patients that had a bariatric surgery; are more prone to bezoar formation due to their potential eating disorders and because of the gastro-enterostomy made to a small gastric pouch after the Roux-en-Y gastric bypass surgery.

Conclusion: Possibility of a bezoar formation should be kept in mind in Roux-en-Y gastric bypass patients who has nausea and vomiting complaints. Removal of the bezoar provides a dramatic improvement in the complaints of these patients.

Keywords: Bariatric surgery; Diabetes; Interventional endoscopy; Postoperative complications.

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Figures

Fig. 1
Fig. 1
Endoscopic view of the bezoar.
Fig. 2
Fig. 2
Bezoar that was fragmented and removed by the endoscopy with the snare.
Fig. 3
Fig. 3
Bezoar in the upper GI barium contrast study.
Fig. 4
Fig. 4
Bezoar can be seen in the abdominal CT.
Fig. 5
Fig. 5
Endoscopy image of the bezoar that was overlooked in the private hospital.
See this image and copyright information in PMC

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