Perforated duodenal ulcer after laparoscopic gastric bypass.
A patient with a history of a laparoscopic gastric bypass presented with a perforated duodenal ulcer. The ulcer was laparoscopically oversewn, and an omentoplasty was performed. Postoperatively, a broad spectrum antibiotic and a proton pump inhibitor were administrated. Several questions arise regarding the diagnosis and treatment of duodenal ulcers after gastric bypass. What are the diagnostic tools to detect a duodenal ulcer, and how should Helicobacter pylori be diagnosed after gastric bypass? The key question is whether the bypassed stomach should be resected as a definitive treatment for complicated duodenal ulcers.
Gypen
Bart J
BJ
Department of Abdominal, Pediatric and Reconstructive Surgery, University Hospital of Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium. bartgypen@hotmail.com
Hubens
Guy J A
GJ
Hartman
Vera
V
Balliu
Lee
L
Chapelle
Thièry C G
TC
Vaneerdeweg
Wouter
W
D000328:Adult; D004381:Duodenal Ulcer / Q000150:complications*; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D009852:Omentum / Q000637:transplantation; D010439:Peptic Ulcer Perforation / Q000209:etiology*; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation