title: A potential complication of bi-level positive airway pressure after gastric bypass surgery.
abstract: BACKGROUND
  Bi-level positive airway pressure (BIPAP) is a common treatment modality for patients with obstructive sleep apnea (OSA), especially in the morbidly obese population. To our knowledge, there have been no reports of any adverse effects of BIPAP on patients who undergo weight loss surgical procedures.
  
  
  METHODS
  We report 2 patients who were treated with BIPAP in the postoperative period following open Roux-en-Y gastric bypass (RYGBP). Their clinical courses and outcomes are presented.
  
  
  RESULTS
  The patients developed massive bowel distention following treatment with BIPAP and subsequently developed anastomotic leaks.
  
  
  CONCLUSIONS
  BIPAP following RYGBP may not be a completely benign treatment modality. We advise caution and careful monitoring during the use of BIPAP after gastric bypass surgery.
authors.affiliation: Department of Surgery, St Luke's Hospital and Health Network, Bethlehem, PA 18015, USA. tito_vasquez@hotmail.com
authors.forename: Tito L
authors.initials: TL
authors.lastname: Vasquez
authors.forename: Kevin
authors.initials: K
authors.lastname: Hoddinott
mesh_terms: D000713:Anastomosis, Roux-en-Y; D004108:Dilatation, Pathologic / Q000209:etiology; D005260:Female; D015390:Gastric Bypass; D013271:Gastric Dilatation / Q000209:etiology*; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D013270:Stomach / Q000601:surgery*