Acute abdomen due to jejunojejunostomy anastomosis leak after laparoscopic gastric bypass in the third month

Abstract

Today, obesity is observed with an increasing frequency. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the gold standard for the treatment of obesity. With the technological advances in surgery and increasing laparoscopic surgical experience, LRYGBP is performed safely with very low morbidity and mortality rates. Still, the incidence rate of serious complications is 4% and the mortality rate is around 0.1%. Fistula and leaks are the leading complications associated with increased mortality and morbidity. The likelihood of a late leak at the jejunojejunal (JJ) anastomosis is below 0.5%. In our case report, we aimed to present a 27-year-old obese woman who developed an acute abdomen due to a leak at the JJ anastomosis in the third month (10th week) after LRYGBP. This is one of the rare case reports of a late JJ anastomotic leak in the literature. Although rare, this complication that may develop in the late period may be quite fatal and the early intervention will be lifesaving. While laparoscopic methods may be used for the treatment, open surgery may be used in patients with advanced peritonitis who were delayed. It may be suggested that physicians in obesity surgery units and emergency departments should keep in mind the development of potential late JJ anastomotic leaks after LRYGBP and act energetically about their diagnosis and treatment.