Gastrointestinal Bleeding in the Bariatric Patient: What Else Should I Consider?
This chapter briefly reviews the unique causes of gastrointestinal bleeding in bariatric patients who have undergone Roux-en-Y gastric bypass, gastric banding, or sleeve gastrectomy. For all bariatric patients in the early postoperative period, iatrogenic bleeding is of immediate concern. For gastric bypass and sleeve gastrectomy patients, staple line bleeding may occur in the early postoperative period. In the late postoperative period (>30 days from procedure), clinicians should consider marginal ulcers and band erosion for gastric bypass and gastric band patients, respectively. Evaluation of these patients may include radiologic studies, typically in conjunction with endoscopy. Management ranges from proton pump inhibitor (PPI) therapy to emergent surgery.
KeywordsBariatric surgery Gastrointestinal bleeding Roux-en-Y gastric bypass Sleeve gastrectomy Gastric band Marginal ulcer Band erosion
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