Article ID Journal Published Year Pages File Type
4288516 International Journal of Surgery Case Reports 2016 4 Pages PDF
Abstract

•The patients that had a bariatric surgery are candidated to bezoar formation due to their potential eating disorders and because of the gastro-enterostomy.•Gastric bezoar could be overlooked by computed tomography and upper gastrointestinal endoscopy.•Continuous complaints may be a signal of a gastric pouch bezoar.

IntroductionWe aimed to present a patient with gastric pouch bezoar after having a bariatric surgery.Presentation of caseSixty-three years old morbid obese female had a laparoscopic Roux-en-Y gastric bypass surgery 14 months ago. She has lost 88% of her excess body mass index; but started to suffer from nausea, abdominal distention and vomiting lately, especially for the last two months. The initial evaluation by endoscopy, computed tomography (CT) and an upper gastrointestinal contrast series overlooked the pathology in the gastric pouch and did not display any abnormality. However, a second endoscopy revealed a 5 cm in diameter phytobezoar in the gastric pouch which was later endoscopically removed. After the bezoar removal, her complaints relieved completely.DiscussionThe gastric bezoars may be confused with the other pathologies because of the dyspeptic complaints of these patients. The patients that had a bariatric surgery; are more prone to bezoar formation due to their potential eating disorders and because of the gastro-enterostomy made to a small gastric pouch after the Roux-en-Y gastric bypass surgery.ConclusionPossibility of a bezoar formation should be kept in mind in Roux-en-Y gastric bypass patients who has nausea and vomiting complaints. Removal of the bezoar provides a dramatic improvement in the complaints of these patients.

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