title: Strangulation of upper jejunum in subsequent pregnancy following gastric bypass surgery.
abstract: OBJECTIVE
  Gastric bypass is a surgical procedure that is popularly used to treat morbid obesity. Herein, we report a woman who had a rare gastrointestinal complication during the subsequent antepartum period following a gastric bypass surgery.
  
  
  METHODS
  After a Roux-en-Y gastric bypass surgery, a 32-year-old woman had unrelenting epigastria for one week at 36 weeks' gestation. An emergency cesarean delivery, followed by laparotomy, was performed. A female neonate was delivered with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. Strangulation and gangrene of the upper jejunum caused by a fibrous band at the site of the Roux anastomosis were revealed. Segmental resection of the nonviable bowel was performed. The patient experienced a smooth postoperative course.
  
  
  CONCLUSIONS
  The awareness of internal hernias and small bowel strangulation should be addressed when unrelenting epigastric pain is present in women after Roux-en-Y gastric bypass surgery, during their first subsequent pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chia Yi, Taiwan. brien@ms23.hinet.net
authors.forename: Chen-Bin
authors.initials: CB
authors.lastname: Wang
authors.forename: Ching-Chuan
authors.initials: CC
authors.lastname: Hsieh
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Chen
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Lin
authors.forename: Chung-Yuan
authors.initials: CY
authors.lastname: Lee
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Tseng
mesh_terms: D000328:Adult; D005260:Female; D005734:Gangrene / Q000209:etiology; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D007583:Jejunum / Q000098:blood supply* / Q000473:pathology*; D009765:Obesity / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*