title: Late intestinal obstruction due to an intestinal volvulus in a pregnant patient with a previous Roux-en-Y gastric bypass.
abstract: This is a case of a 33 weeks pregnant woman, presented 2 years after laparoscopic Roux-en-Y gastric bypass, with abdominal pain for 2 days. A laparoscopic cholecystectomy was performed 1 day earlier in another hospital, without improving the pain. She presented at our hospital with acute abdominal pain and clinical signs of intestinal obstruction, undergoing an exploratory laparotomy that revealed a volvulus and necrosis of the jejunum from the gastroenteroanastomosis through the lateral enteroenterostomy, which was resected with the reconstruction of the Roux-en-Y limb performed at the same operation. Patient and neonate presented with improvement after surgery and the patient was discharged on postoperative day 15. Internal hernias after bariatric surgery have been reported as the cause of acute abdomen problems during pregnancy, which may progress to necrosis and perforation. The delay of surgical intervention could have brought a tragic outcome for mother and neonate.
authors.affiliation: General Surgery Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (Federal University of Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Anajara
authors.initials: A
authors.lastname: Gazzalle
authors.forename: Débora
authors.initials: D
authors.lastname: Braun
authors.forename: Leandro Totti
authors.initials: LT
authors.lastname: Cavazzola
authors.forename: Luiz Roberto
authors.initials: LR
authors.lastname: Wendt
authors.forename: Daniel
authors.initials: D
authors.lastname: Navarini
authors.forename: Marcelo de Azevedo
authors.initials: Mde A
authors.lastname: Fauri
authors.forename: Santo Pascual
authors.initials: SP
authors.lastname: Vitola