ABSTRACT
BACKGROUND: Phytobezoar formation is a complication of bariatric surgery and mostly occurs after laparoscopic Roux-en-Y gastric bypass (LRYGB) operations. Here, we present an extremely rare case of late phytobezoar formation following laparoscopic sleeve gastrectomy (LSG). CASE PRESENTATION: A 52-year-old woman with a body mass index (BMI) of 40.7 kg/m2 underwent LSG. Following persistent symptoms of nausea, vomiting, early satiety, and tremendous weight loss, endoscopy was performed, and gastric phytobezoar was detected at one-year post-operation. After endoscopic fragmentation, phytobezoar was removed by snare, and the patient later underwent redo bariatric surgery (conversion of LSG to LRYGB). CONCLUSIONS: With an increase in the number of LSG procedures performed globally, and the late-onset nature of phytobezoar formation, more cases of this complication are expected to be detected in future. Long-term postoperative follow-up alongside applying surgical methods to avoid gastric stenosis are needed to reduce the chance of phytobezoar formation in patients undergoing LSG.
Subject(s)
Bariatric Surgery , Gastric Bypass , Laparoscopy , Obesity, Morbid , Bariatric Surgery/adverse effects , Female , Gastrectomy/adverse effects , Humans , Middle Aged , Obesity, Morbid/surgery , Postoperative Complications/etiology , Postoperative Complications/surgery , Treatment OutcomeABSTRACT
BACKGROUND: Obesity is a major health concern in the Middle East and worldwide. It is among the leading causes of morbidity, mortality, health care utilization, and costs. With bariatric surgery proving to be a more effective treatment option for overweight and obesity, the need for systematic assessment of different procedures and their outcomes becomes necessary. These procedures have not yet been described in detail in our region. OBJECTIVE: We aim to undertake a prospective study evaluating and comparing several surgical bariatric procedures in an Iranian population of morbid obese patients presenting to a specialized bariatric center. METHODS: In order to facilitate and accelerate understanding of obesity and its complications, the Tehran Obesity Treatment Study (TOTS) was planned and developed. This study is a longitudinal prospective cohort study in consecutive patients undergoing bariatric surgery. TOTS investigators use standardized definitions, high-fidelity data collection system, and validated instruments to gather data preoperatively, at the time of surgery, postoperatively, and in longer-term follow-up. RESULTS: This study has recruited 1050 participants as of September 2015 and is ongoing. CONCLUSIONS: This study will ensure creation of high-level evidence to enable clinicians to make meaningful evidence-based decisions for patient evaluation, selection for surgery, and follow-up care.
ABSTRACT
INTRODUCTION: Bowel obstruction is a known complication after bariatric surgery especially Roux-en-Y gastric bypass. The known etiologies include internal hernia, jejunojejunostomy stricture, ileus, intussusceptions, superior mesenteric artery syndrome, incarcerated port site hernia, and adhesions. Blood bezoar is a rare cause of small intestinal obstruction after Roux-en-Y gastric bypass. PRESENTATION OF CASE: We are going to present two cases of small bowel obstruction after Roux-en-Y gastric bypass due to blood bezoar. DISCUSSION: Blood clot as the etiology of small bowel obstruction after Roux-en-Y gastric bypass is an unusual event. In the presence of postoperative small intestinal obstruction an obstructive blood bezoar should be in differential diagnosis. As any other etiology of postoperative obstruction it should be treated immediately to prevent its adverse lethal complications. CONCLUSION: The best way for prevention of blood bezoar is prevention of bleeding at staple line and doing hemostasis at stapler line.
ABSTRACT
Schwannomas or neurilemomas are rare, benign tumors that originate from the neural sheath. A 54-year-old man presented with left flank discomfort and lumbar pain for 6 months. A computed tomographic scan confirmed the existence of a 12 × 9 cm heterogeneous retroperitoneal mass adherent to the left psoas muscle that displaced the left kidney anteriorly. Total laparoscopic removal of the tumor was performed and pathologic examination revealed a benign schwannoma.
