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Chronic Abdominal Pain After Roux-en-Y Gastric Bypass

  • Pearl Ma
  • Kelvin Higa
Chapter

Abstract

The surgical and physiologic construct of Roux-en-Y gastric bypass (RYGB) leads to a unique set of potential complications that require routine follow-up by an experienced bariatric surgeon. Chronic abdominal pain after RYGB is particularly challenging and often requires thoughtful workup and possible surgical intervention. Patient history and physical examinations must be thorough, confirmed with radiographic imaging to support the diagnosis. Most common causes of abdominal pain after surgery include internal hernia, marginal ulcers, and adhesions causing intermittent bowel obstructions. Less frequent pathologies such as intussusception at the jejunojejunostomy, suture bezoars, candy cane (afferent limb) deformity, biliary pathology, and remnant gastritis can present with less obvious and consistent symptoms. Often, radiographic and endoscopic evaluations will be negative. Therefore, surgeons should have a low threshold for exploring post-RYGB patients for abdominal pain.

Keywords

Abdominal pain Chronic Complications Roux-en-Y gastric bypass 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Pearl Ma
    • 1
    • 2
  • Kelvin Higa
    • 1
    • 2
  1. 1.Department of SurgeryUniversity of California San Francisco-FresnoFresnoUSA
  2. 2.Fresno Heart and Surgical HospitalFresnoUSA

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