gastric bypass surgery

Question 1

What are the late complications of gastric bypass surgery?

Answer 1

Small bowel obstruction (adhesions, internal hernias, volvulus).
Anastomotic strictures.
Marginal ulcers.
Nutritional deficiencies (e.g., vitamin B12, iron).

Question 2

What clinical features suggest small bowel obstruction (SBO)?

Answer 2

Severe, crampy abdominal pain.
Nausea and vomiting (bilious if obstruction is distal).
Abdominal distension.
Absence of flatus or bowel movements.

Question 3

What imaging study is most useful in diagnosing SBO?

Answer 3

Abdominal CT scan: Helps identify the obstruction site, severity, and complications (e.g., strangulation, herniation).

Question 4

Why is bilious vomiting significant in small bowel obstruction?

Answer 4

It indicates that the obstruction is distal to the ampulla of Vater, as bile from the common bile duct can enter the proximal small bowel.

Question 5

What is the most common cause of small bowel obstruction in patients with a history of abdominal surgery?

Answer 5

Scar tissue from prior surgeries can create mechanical obstruction.

Question 6

How do internal hernias cause small bowel obstruction after gastric bypass?

Answer 6

Altered anatomy allows bowel loops to become trapped in abnormal spaces, leading to obstruction and ischemia.