Presentation
All patients presented with iron deficiency anemia with evidence of gastrointestinal (GI) blood loss and this was the indication for colonoscopy. [ncbi.nlm.nih.gov]
We report the case of a 63-year-old male patient who presented 6 years after ileocolic resection, and also review the data of six similar cases described in the literature. [hungary.pure.elsevier.com]
She acutely presented to our emergency department with abdominal pain and melena. She was diagnosed with an actively bleeding anastomotic ulcer in the efferent jejunal limb. [sages.org]
Gastrointestinal
- Abdominal Pain
She acutely presented to our emergency department with abdominal pain and melena. She was diagnosed with an actively bleeding anastomotic ulcer in the efferent jejunal limb. [sages.org]
The usual complaint is upper abdominal pain, which is often aggravated by eating and improved by antacids. In some patients, the pain is felt more to the left in the epigastrium, and left axillary or shoulder pain is occasionally reported. [for-surgeons.com]
Nausea, vomiting, and abdominal pain after Roux-en-Y anastomosis: motility of the jejunal limb. Gastroenterology 1985;88:101-107. 9. Washer GF, Gear MWL, Dowling BL, Gillison EW, Royston CMS, Spencer J. [hon.ch]
Absence of abdominal pain in older persons with endoscopic ulcers: a prospective study. Am J Gastroenterol. 2001;96:380–4. 17. Martinez JP, Mattu A. Abdominal pain in the elderly. Emerg Med Clin North Am. 2006;24:371–88. 18. Hassall E. [aafp.org]
- Nausea
Postoperatively she suffered from nausea and vomiting and was unable to tolerate an oral diet. She had undergone repeated balloon dilatations without any success. She acutely presented to our emergency department with abdominal pain and melena. [sages.org]
Early Early complications of gastrointestinal complications of gastric bypass surgery include 3 : anastomotic leak : usually at the gastrojejunal anastomosis acute ischemia Late anastomotic narrowing/stenosis/stricture most common cause of postoperative nausea [radiopaedia.org]
This usually causes no symptom; however, some patients develop persistent burning epigastric pain and chronic nausea that is aggravated by meals. There is no effective treatment. [gastrotraining.com]
Blind loop syndrome (sometimes called stasis syndrome or stagnant loop syndrome) - this affects digestion and absorption, causing: Bloating, loss of appetite, abdominal pain and nausea. Fatty stools (steatorrhoea). Diarrhoea with weight loss. [patient.info]
Early Dumping syndrome (fast heartbeat, nausea, vomiting, fainting, sweating and diarrhea) is often a side effect of the operation. Adhering to a sugar free diet will aid in minimizing this syndrome. [alweightlosscenter.com]
Workup
Her initial workup at the outside facility included a Computer Tomography (CT) scan and a nuclear medicine bleeding scan, both of which did not reveal any acute pathology. [omicsonline.org]
X-Ray
- Gastric Fistula
A high acid milieu can arise from a dilated gastric reservoir or, in the setting of a gastro-gastric fistula, the acid produced in the gastric remnant can reflux into the gastric pouch via the fistula and break down the mucosal integrity. [bariatrictimes.com]
As an AU could not be detected further diagnostic investigations were performed: Upper gastrointestinal (GI) contrast series revealing a small gastric pouch without signs of a gastric fistula and normal passage. [bmcsurg.biomedcentral.com]
Further investigation was carried out by means of an upper GI series that revealed a sharpened contrast passage through the anastomosis; there was no gastro-gastric fistula. [aischannel.com]
Capella JF, Capella RF (1999) Gastro-gastric fistulas and marginal ulcers in gastric bypass procedures for weight reduction. Obes Surg 9:22–27 PubMed CrossRef Google Scholar 7. [link.springer.com]
Treatment
Elective operative treatment with resection of the anastomosis is, in the hands of a bariatric surgeon, a safe and effective treatment for these cases. [sages.org]
In case of AU recurrence, 56% continue with conservative treatment. [ncbi.nlm.nih.gov]
These figures were accumulated before the emergence of effective treatment against H pylori, however, and are likely to be lower with current management. [for-surgeons.com]
Treatment of Peptic Ulcer Disease Figure 1. Algorithm for the treatment of peptic ulcer disease. [aafp.org]
Prognosis
Seite 79 - T et al (1995) Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer, Comparison of threefield lymphadenectomy with two-field lymphadenectomy. [books.google.de]
Difficulty in detecting recurrence at an early stage was considered to be one of the reasons for the relatively poor prognosis of anastomotic recurrence. [academic.oup.com]
BD patients with GI lesions are subcategorized as intestinal BD because these patients often have severe GI complications and a poor prognosis. [springerplus.springeropen.com]
Prognosis in patients with upper GI bleeding. Am Fam Physician. 2004;70:2348–50. 32. Leontiadis GI, Sharma VK, Howden CW. [aafp.org]
Etiology
The markedly reduced bile acid absorption found in our case raises the possibility of an etiological role of bile acids in the development of ileocolic anastomotic ulcers. [hungary.pure.elsevier.com]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Epidemiology
Farraye, MD, MSc is an Associate Professor of Medicine and Epidemiology at the Boston University School of Medicine in Boston, Mass. [books.google.de]
Epidemiology: What do we know about marginal ulcers? Marginal ulcers represent one of the most problematic postoperative complications following Roux-en-Y gastric bypass (RYGB). [bariatrictimes.com]
Incidence of serious upper gastrointestinal bleeding/perforation in the general population: review of epidemiologic studies. J Clin Epidemiol. 2002;55:157–63. 30. Rockall TA, Logan RF, Devlin HB, Northfield TC. [aafp.org]
Pathophysiology
Schirmer, Stacy Brethauer Springer Science & Business Media, 11 sept. 2008 - 523 pagini "Minimally Invasive Bariatric Surgery" covers the full spectrum of laparoscopic weight loss surgery and the pathophysiology of obesity. [books.google.ro]
These surgical technique issues may be more important for early stricture formation, but are less likely to help in understanding the pathophysiology of many later post-operative anastomotic strictures. [ghrnet.org]
Prevention
In an international survey among members of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), current preventative and therapeutic strategies in AU were analyzed. METHODS: An Internet-based survey was performed. [ncbi.nlm.nih.gov]
Little attention has therefore been paid to the prevention of anastomotic recurrence of proximal colonic carcinomas. [academic.oup.com]
Taking a multivitamin with iron usually prevents this problem. Vitamin B12 supplements may also be necessary to prevent anemia. [alweightlosscenter.com]
In addition, while prevention is key, it is often difficult to achieve. [bariatrictimes.com]
[…] gastro-oesophageal reflux disease, treatment and prophylaxis of NSAID-associated gastric and duodenal ulcers, Zollinger-Ellison syndrome, and in combination with appropriate antibacterial therapeutic regimens for the eradication of Helicobacter pylori and prevention [de.glosbe.com]