title: Pregnant woman with fatal complication after laparoscopic Roux-en-Y gastric bypass.
abstract: In Europe, an increasing number of women have bariatric surgery; therefore, obstetricians are likely to encounter these patients. We report a 22-year-old woman, who had previously undergone uncomplicated laparoscopic Roux-en-Y gastric bypass. She was admitted with severe abdominal pain at 35 weeks of gestation. A cesarean section with delivery of a healthy baby in combination with an exploratory laparotomy was performed. Internal herniation was suspected, but not identified during surgery. Three days later she died of a severely gangrenous small bowel secondary to internal herniation. This fatal case illustrates a potential complication and difficulties in the management of pregnant women who have undergone Roux-en-Y gastric bypass. In these women, observation and investigations based on a multidisciplinary approach are vital if abdominal pain develops, with involvement of intestinal surgeons experienced in bariatric surgery, as well as radiologists with specific knowledge of relevant imaging procedures.
authors.affiliation: Department of Obstetrics and Gynaecology, Hvidovre Hospital, University Hospital of Copenhagen, Copenhagen, Denmark. krta@dadlnet.dk
authors.forename: Kristina
authors.initials: K
authors.lastname: Renault
authors.forename: Hans Jørgen
authors.initials: HJ
authors.lastname: Gyrtrup
authors.forename: Karen
authors.initials: K
authors.lastname: Damgaard
authors.forename: Morten
authors.initials: M
authors.lastname: Hedegaard
authors.forename: Jette Led
authors.initials: JL
authors.lastname: Sørensen
mesh_terms: D002585:Cesarean Section; D017809:Fatal Outcome; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D011247:Pregnancy; D055815:Young Adult