Abdominal pain after gastric bypass: Suspects and solutions

American Journal of Surgery

Volumn 201, Issue 6, 2011, Pages 819-827

  Greenstein, Alexander J ^a   O'Rourke, Robert W ^a  

^a OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

Author keywords

Abdominal pain; Gastric bypass; Internal hernia; Laparoscopy; Obesity

Indexed keywords

ABDOMINAL PAIN; ABDOMINAL WALL HERNIA; CHOLANGITIS; CHOLECYSTITIS; CHOLELITHIASIS; COMMON BILE DUCT STONE; CONSTIPATION; DIARRHEA; DIFFERENTIAL DIAGNOSIS; ESOPHAGUS FUNCTION DISORDER; FLATULENCE; GASTROESOPHAGEAL REFLUX; HIATUS HERNIA; HUMAN; INTERNAL HERNIA; INTUSSUSCEPTION; IRRITABLE COLON; NUTRITIONAL DEFICIENCY; NUTRITIONAL INTOLERANCE; OUTCOME ASSESSMENT; OVERNUTRITION; PATHOGENESIS; PEPTIC ULCER; POSTGASTRECTOMY SYNDROME; PRIORITY JOURNAL; REVIEW; STOMACH BYPASS; STOMACH FISTULA;

ABDOMINAL PAIN; DIAGNOSIS, DIFFERENTIAL; GASTRIC BYPASS; HUMANS; LAPAROSCOPY; OBESITY, MORBID; PAIN, POSTOPERATIVE;

EID: 79960188117     PISSN: 00029610     EISSN: 18791883     Source Type: Journal    
DOI: 10.1016/j.amjsurg.2010.05.007     Document Type: Review

References (96)

1. H.P. Santry, D.L. Gillen, and D.S. Lauderdale Trends in bariatric surgical procedures JAMA 294 2005 1909 1917 (Pubitemid 41464692)
2. M. Cho, O. Kaidar-Person, and S. Szomstein Emergency room visits after laparoscopic Roux-en-Y gastric bypass for morbid obesity Surg Obes Relat Dis 4 2008 104 109 (Pubitemid 351396205)
3. J. Saunders, G.H. Ballantyne, and S. Belsley One-year readmission rates at a high volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and vertical banded gastroplasty-Roux-en-Y gastric bypass Obes Surg 18 2008 1233 1240
4. T.A. Kellogg, T. Swan, and D.A. Leslie Patterns of readmission and reoperation within 90 days after Roux-en-Y gastric bypass Surg Obes Relat Dis 5 2009 416 423
5. A. Foster, W.O. Richards, and J. McDowell Gastrointestinal symptoms are more intense in morbidly obese patients Surg Endosc 17 2003 1766 1768 (Pubitemid 37553812)
6. C.H. Arasaki, J.C. Del Grande, and E.T. Yanagita Incidence of regurgitation after the banded gastric bypass Obes Surg 15 2005 1408 1417 (Pubitemid 41746415)
7. S.P. Walker, P. Wein, and B.U. Ihle Severe folate deficiency masquerading as the syndrome of hemolysis, elevated liver enzymes, and low platelets Obstet Gynecol 90 1997 655 657 (Pubitemid 27413291)
8. G.A. Decker, J.K. DiBaise, and J.A. Leighton Nausea, bloating and abdominal pain in the Roux-en-Y gastric bypass patient: more questions than answers Obes Surg 17 2007 1529 1533
9. J. Faintuch, R.K. Ishida, and M. Jacabi Increased gastric cytokine production after Roux-en-Y gastric bypass for morbid obesity Arch Surg 142 2007 962 968 (Pubitemid 47607604)
10. G.A. Woodard, B. Encarnacion, and J.R. Downey Probiotics improve outcomes after Roux-en-Y gastric bypass surgery: a prospective randomized trial J Gastrointest Surg 13 2009 1198 1204
11. R.K. Ishida, J. Faintuch, and A.M. Paula Microbial flora of the stomach after gastric bypass for morbid obesity Obes Surg 17 2007 752 758 (Pubitemid 46999039)
12. J.D. Machado, C.S. Campos, and D. Lopes Intestinal bacterial overgrowth after Roux-en-Y gastric bypass Obes Surg 18 2008 139 143
13. R.M. Dallal, and D. Cottam Candy cane Roux syndromea possible complication after gastric bypass surgery Surg Obes Relat Dis 3 2007 408 410 (Pubitemid 46796762)
14. J.E. Teitelbaum, P. Sinha, and M. Micale Obesity is related to multiple functional abdominal diseases J Pediatr 154 2009 444 446
15. M. Suter, G. Dorta, and V. Giusti Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients Obes Surg 14 2004 959 966 (Pubitemid 39093471)
16. N. Potoczna, S. Harfmann, and R. Steffen Bowel habits after bariatric surgery Obes Surg 18 2008 1287 1296
17. P. Svedberg, S. Johansson, and M.A. Wallander Extra-intestinal manifestations associated with irritable bowel syndrome: a twin study Aliment Pharmacol Ther 16 2002 975 983 (Pubitemid 34461768)
18. D. Hong, Y.S. Khajanchee, and N. Pereira Manometric abnormalities and gastroesophageal reflux disease in the morbidly obese Obes Surg 14 2004 744 749 (Pubitemid 38982256)
19. M. Merrouche, J.M. Sabaté, and P. Jouet Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients before and after bariatric surgery Obes Surg 17 2007 894 900 (Pubitemid 350042917)
20. H. Yamamoto, T. Mori, and H. Tsuchihashi A possible role of GLP-1 in the pathophysiology of early dumping syndrome Dig Dis Sci 50 2005 2263 2267 (Pubitemid 43106379)
21. G.J. Service, G.B. Thompson, and F.J. Service Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery N Engl J Med 353 2005 249 254 (Pubitemid 41058324)
22. T.A. Kellogg, J.P. Bantle, and D.B. Leslie Postgastric bypass hyperinsulinemic hypoglycemia syndrome: characterization and response to a modified diet Surg Obes Relat Dis 4 2008 492 499 (Pubitemid 352006166)
23. R.O. Moreira, R.B. Moreira, and N.A. Machado Post-prandial hypoglycemia after bariatric surgery: pharmacological treatment with verapamil and acarbose Obes Surg 18 2008 1618 1621
24. N. Guseva, D. Phillips, and J.P. Mordes Successful treatment of persistent hyperinsulinemic hypoglycemia with nifedipine in an adult patient Endocr Pract 16 2010 107 111
25. K. Z'graggen, A. Guweidhi, and R. Steffen Severe recurrent hypoglycemia after gastric bypass surgery Obes Surg 18 2008 981 988
26. D. Mikami, B. Needleman, and V. Narula Natural orifice surgery: initial US experience utilizing the StomaphyX device to reduce gastric pouches after Roux-en-Y gastric bypass Surg Endosc 24 2010 223 228
27. L.J. Wudel Jr, J.K. Wright, and J.P. Debelak Prevention of gallstone formation in morbidly obese patients undergoing rapid weight loss: results of a randomized controlled pilot study J Surg Res 102 2002 50 56
28. D.E. Swartz, and E.L. Felix Elective cholecystectomy after Roux-en-Y gastric bypass: why should asymptomatic gallstones be treated differently in morbidly obese patients? Surg Obes Relat Dis 1 2005 555 560
29. D.D. Portenier, J.P. Grant, and H.S. Blackwood Expectant management of the asymptomatic gallbladder at Roux-en-Y gastric bypass Surg Obes Relat Dis 3 2007 476 479 (Pubitemid 47055403)
30. O.N. Tucker, P. Fajnwaks, and S. Szomstein Is concomitant cholecystectomy necessary in obese patients undergoing laparoscopic gastric bypass surgery? Surg Endosc 22 2008 2450 2454
31. K. Miller, E. Hell, and B. Lang Gallstone formation prophylaxis after gastric restrictive procedures for weight loss: a randomized double-blind placebo-controlled trial Ann Surg 238 2003 697 702 (Pubitemid 38182261)
32. E.E. Mason, and K.E. Renquist Gallbladder management in obesity surgery Obes Surg 12 2002 222 229 (Pubitemid 34442083)
33. A. Nougou, and M. Suter Almost routine prophylactic cholecystectomy during laparoscopic gastric bypass is safe Obes Surg 18 2008 535 539
34. K.R. Patel, S.C. White, and T. Tejirian Gallbladder management during laparoscopic Roux-en-Y gastric bypass surgery: routine preoperative screening for gallstones and postoperative prophylactic medical treatment are not necessary Am Surg 72 2006 857 861 (Pubitemid 351837618)
35. W. Fuller, J.J. Rasmussen, and J. Ghosh Is routine cholecystectomy indicated for asymptomatic cholelithiasis in patients undergoing gastric bypass? Obes Surg 17 2007 747 751 (Pubitemid 46999038)
36. J.I. Mechanick, R.F. Kushner, and H.J. Sugerman American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient Obesity 17 Suppl 1 2009 S1 S70 v
37. A.M. Paganini, M. Guerrieri, and J. Sarnari Thirteen years' experience with laparoscopic transcystic common bile duct exploration for stones Effectiveness and long-term results Surg Endosc 21 2007 34 40 (Pubitemid 44951345)
38. A.R. Ahmed, S. Husain, and N. Saad Accessing the common bile duct after Roux-en-Y gastric bypass Surg Obes Relat Dis 3 2007 640 643 (Pubitemid 350091410)
39. G. Peeters, and J. Himpens Laparoscopically assisted transgastric endoscopy in Roux-en-Y gastric bypass: a modification of the technique Endoscopy 41 Suppl 2 2009 E190
40. K.A. Morgan, J.B. Glenn, and T.K. Byrne Sphincter of Oddi dysfunction after Roux-en-Y gastric bypass Surg Obes Relat Dis 5 2009 571 575
41. J.J. Rasmussen, W. Fuller, and M.R. Ali Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients Surg Endosc 21 2007 1090 1094 (Pubitemid 47024767)
42. J.C. Vasquez, D. Wayne Overby, and T.M. Farrell Fewer gastrojejunostomy strictures and marginal ulcers with absorbable suture Surg Endosc 23 2009 2011 2015
43. M. Stanczyk, C.W. Deveney, and S.A. Traxler Gastrogastric fistula in the era of divided Roux-en-Y gastric bypass: strategies for prevention, diagnosis, and management Obes Surg 16 2006 359 364
44. Y.D. Podnos, J.C. Jimenez, and S.E. Wilson Complications after laparoscopic gastric bypass: a review of 3464 cases Arch Surg 138 2003 957 961 (Pubitemid 37099869)
45. J.F. Capella, and R.F. Capella Gastro-gastric fistulas and marginal ulcers in gastric bypass procedures for weight reduction Obes Surg 9 1999 22 27
46. L. Carrodeguas, S. Szomstein, and F. Soto Management of gastrogastric fistula after divided Roux-en-Y gastric bypass surgery for morbid obesity: analysis of 1292 consecutive patients and review of literature Surg Obes Relat Dis 1 2005 467 474
47. J.C. Torres, C.F. Oca, and R.N. Garrison Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvature South Med J 76 1983 1217 1221 (Pubitemid 14226104)
48. H. Siilin, A. Wanders, and S. Gustavsson The proximal gastric pouch invariably contains acid-producing parietal cells in Roux-en-Y gastric bypass Obes Surg 15 2005 771 777 (Pubitemid 40904864)
49. K.E. Behrns, C.D. Smith, and K.A. Kelly Reoperative bariatric surgery Lessons learned to improve patient selection and results Ann Surg 218 1993 646 653 (Pubitemid 23339118)
50. J.A. Sapala, M.H. Wood, and M.A. Sapala The micropouch gastric bypass: technical considerations in primary and revisionary operations Obes Surg 11 2001 3 17 (Pubitemid 32165635)
51. E.H. Chin, D. Hazzan, and U. Sarpel Multimedia article Laparoscopic repair of a perforated marginal ulcer 2 years after gastric bypass Surg Endosc 21 2007 2110 (Pubitemid 47620291)
52. B.A. Coakley, C.W. Deveney, and D.H. Spight Revisional surgery for failed restrictive bariatric operations Surg Obes Relat Dis 4 2008 581 586
53. C.W. Hartin Jr, D.S. Remine, and T.A. Lucktong Preoperative bariatric screening and treatment of Helicobacter pylori Surg Endosc 23 2009 2531 2534
54. A. de Moura Almeida, H.P. Cotrim, and A.S. Santos Preoperative upper gastrointestinal endoscopy in obese patients undergoing bariatric surgery: is it necessary? Surg Obes Relat Dis 4 2008 144 149
55. P.K. Papasavas, D.J. Gagné, and P.E. Donnelly Prevalence of Helicobacter pylori infection and value of preoperative testing and treatment in patients undergoing laparoscopic Roux-en-Y gastric bypass Surg Obes Relat Dis 4 2008 383 388 (Pubitemid 351682364)
56. B.C. Sacks, S.G. Mattar, and F.G. Qureshi Incidence of marginal ulcers and the use of absorbable anastomotic sutures in laparoscopic Roux-en-Y gastric bypass Surg Obes Relat Dis 2 2006 11 16
57. R.D. Pai, D.L. Carr-Locke, and C.C. Thompson Endoscopic evaluation of the defunctionalized stomach by using ShapeLock technology (with video) Gastrointest Endosc 66 2007 578 581 (Pubitemid 47296327)
58. T.H. Baron Double-balloon enteroscopy to facilitate retrograde PEG placement as access for therapeutic ERCP in patients with long-limb gastric bypass Gastrointest Endosc 64 2006 973 974 (Pubitemid 44820080)
59. C.A. Madalosso, R.R. Gurski, and S.M. Callegari-Jacques The impact of gastric bypass on gastroesophageal reflux disease in patients with morbid obesity: a prospective study based on the Montreal consensus Ann Surg 251 2010 244 248
60. N.L. De Groot, J.S. Burgerhart, and P.C. Van De Meeberg Systematic review: the effects of conservative and surgical treatment for obesity on gastro-oesophageal reflux disease Aliment Pharmacol Ther 30 2009 1091 1102
61. D.E. Swartz, E. Mobley, and E.L. Felix Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain Surg Obes Relat Dis 5 2009 27 30
62. B.A. Flanagin, M.T. Mitchell, and W.A. Thistlethwaite Diagnosis and treatment of atypical presentations of hiatal hernia following bariatric surgery Obes Surg 20 2010 386 392
63. A. Mathew, M.A. Veliuona, and F.J. DePalma Gastrojejunal stricture after gastric bypass and efficacy of endoscopic intervention Dig Dis Sci 54 2009 1971 1978
64. W.J. Suggs, W. Kouli, and M. Lupovici Complications at gastrojejunostomy after laparoscopic Roux-en-Y gastric bypass: comparison between 21-and 25-mm circular staplers Surg Obes Relat Dis 3 2007 508 514 (Pubitemid 47440675)
65. C.C. Chiu, W.J. Lee, and W. Wang Prevention of trocar-wound hernia in laparoscopic bariatric operations Obes Surg 16 2006 913 918 (Pubitemid 44133482)
66. W.H. Johnson, A.M. Fecher, and R.L. McMahon Trocar hernia rate in unclosed fascial defects in bariatric patients Surg Endosc 20 2006 1584 1586 (Pubitemid 44451231)
67. S. Husain, A.R. Ahmed, and J. Johnson Small-bowel obstruction after laparoscopic Roux-en-Y gastric bypass: etiology, diagnosis, and management Arch Surg 142 2007 988 993 (Pubitemid 47607607)
68. G. Gunabushanam, S. Shankar, and D.R. Czerniach Small-bowel obstruction after laparoscopic Roux-en-Y gastric bypass surgery J Comput Assist Tomogr 33 2009 369 375
69. K.D. Higa, T. Ho, and K.B. Boone Internal hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment and prevention Obes Surg 13 2003 350 354 (Pubitemid 36718451)
70. R.W. Bauman, and J.R. Pirrello Internal hernia at Petersen's space after laparoscopic Roux-en-Y gastric bypass 6.2 % incidence without closurea single surgeon series of 1047 cases Surg Obes Relat Dis 5 2009 565 570
71. M.A. Schweitzer, E.J. DeMaria, and T.J. Broderick Laparoscopic closure of mesenteric defects after Roux-en-Y gastric bypass J Laparoendosc Adv Surg Tech A 10 2000 173 175 (Pubitemid 30439701)
72. A. Paroz, J.M. Calmes, and V. Giusti Internal hernia after laparoscopic Roux-en-Y gastric bypass for morbid obesity: a continuous challenge in bariatric surgery Obes Surg 16 2006 1482 1487 (Pubitemid 44759982)
73. E. Garza Jr, J. Kuhn, and D. Arnold Internal hernias after laparoscopic Roux-en-Y gastric bypass Am J Surg 188 2004 796 800
74. J.K. Champion, and M. Williams Small bowel obstruction and internal hernias after laparoscopic Roux-en-Y gastric bypass Obes Surg 13 2003 596 600 (Pubitemid 36951739)
75. B. Carmody, E.J. DeMaria, and M. Jamal Internal hernia after laparoscopic Roux-en-Y gastric bypass Surg Obes Relat Dis 1 2005 543 548
76. M. Cho, D. Pinto, and L. Carrodeguas Frequency and management of internal hernias after laparoscopic antecolic antegastric Roux-en-Y gastric bypass without division of the small bowel mesentery or closure of mesenteric defects: review of 1400 consecutive cases Surg Obes Relat Dis 2 2006 87 91
77. G.M. Torres-Villalobos, T.A. Kellogg, and D.B. Leslie Small bowel obstruction and internal hernias during pregnancy after gastric bypass surgery Obes Surg 19 2009 944 950
78. K.E. Steele, G.P. Prokopowicz, and T. Magnuson Laparoscopic antecolic Roux-en-Y gastric bypass with closure of internal defects leads to fewer internal hernias than the retrocolic approach Surg Endosc 22 2008 2056 2061
79. A. Paroz, J.M. Calmes, and S. Romy A new type of internal hernia after laparoscopic Roux-en-Y gastric bypass Obes Surg 19 2009 527 530
80. R.Y. Patel, J.W. Baer, and J. Texeira Internal hernia complications of gastric bypass surgery in the acute setting: spectrum of imaging findings Emerg Radiol 16 2009 283 289
81. J.D. Iannuccilli, D. Grand, and B.L. Murphy Sensitivity and specificity of eight CT signs in the preoperative diagnosis of internal mesenteric hernia following Roux-en-Y gastric bypass surgery Clin Radiol 64 2009 373 380
82. M.E. Lockhart, F.N. Tessler, and C.L. Canon Internal hernia after gastric bypass: sensitivity and specificity of seven CT signs with surgical correlation and controls AJR Am J Roentgenol 188 2007 745 750
83. A.D. Gandhi, R.A. Patel, and R.E. Brolin Elective laparoscopy for herald symptoms of mesenteric/internal hernia after laparoscopic Roux-en-Y gastric bypass Surg Obes Relat Dis 5 2009 144 149
84. E.A. Agaba, C.V. Gentles, and H. Shamseddeen Retrospective analysis of abdominal pain in postoperative laparoscopic Roux-en-Y gastric bypass patients: is a simple algorithm the answer? Surg Obes Relat Dis 4 2008 587 593
85. T. Pitt, S. Brethauer, and V. Sherman Diagnostic laparoscopy for chronic abdominal pain after gastric bypass Surg Obes Relat Dis 4 2008 394 398
86. D.D. Coster, S.M. Sundberg, and D.S. Kermode Small bowel obstruction due to antegrade and retrograde intussusception after gastric bypass: three case reports in two patients, literature review, and recommendations for diagnosis and treatment Surg Obes Relat Dis 4 2008 69 72
87. K. Zainabadi, and R. Ramanathan Intussusception after laparoscopic Roux-en-Y gastric bypass Obes Surg 17 2007 1619 1623
88. M.P. Hocking, D.M. McCoy, and S.B. Vogel Antiperistaltic and isoperistaltic intussusception associated with abnormal motility after Roux-en-Y gastric bypass: a case report Surgery 110 1991 109 112
89. M.S. Srikanth, T. Keskey, and S.R. Fox Computed tomography patterns in small bowel obstruction after open distal gastric bypass Obes Surg 14 2004 811 822 (Pubitemid 38982268)
90. M. Cho, L. Carrodeguas, and D. Pinto Diagnosis and management of partial small bowel obstruction after laparoscopic antecolic antegastric Roux-en-Y gastric bypass for morbid obesity J Am Coll Surg 202 2006 262 268 (Pubitemid 43112485)
91. C.E. Lewis, C. Jensen, and T. Tejirian Early jejunojejunostomy obstruction after laparoscopic gastric bypass: case series and treatment algorithm Surg Obes Relat Dis 5 2009 203 207
92. T.J. Bestman, J.W. Valk, and B. Gypen An unusual complication after Roux-en-Y gastric bypass: torsion and infarction of the divided omentum Obes Surg 19 2009 1731 1733
93. R.M. Dallal, and L.A. Bailey Omental infarction: a cause of acute abdominal pain after antecolic gastric bypass Surg Obes Relat Dis 2 2006 451 454 (Pubitemid 44028842)
94. D. Goitein, D.J. Gagné, and P.K. Papasavas Superior mesenteric artery syndrome after laparoscopic Roux-en-Y gastric bypass for morbid obesity Obes Surg 14 2004 1008 1011 (Pubitemid 39093479)
95. J.S. Pratt, M. Van Noord, and E. Christison-Lagay The tethered bezoar as a delayed complication of laparoscopic Roux-en-Y gastric bypass: a case report J Gastrointest Surg 11 2007 690 692
96. K. Steele, M. Schweitzer, and A. Lidor Unusual case of gastric bezoar causing obstruction after Roux-en-Y gastric bypass Surg Obes Relat Dis 2 2006 536 537 (Pubitemid 44464084)