title: [Perforated duodenal ulcer in a Roux-en-Y gastric bypass operated patient can be a diagnostic challenge].
abstract: Roux-en-Y gastric bypass (RYGBP) is an increasingly used procedure when treating morbid obesity. Due to the extensive gastrointestinal rearrangement, diagnostic evaluation of patients with gastric bypass and acute abdominal pain can be difficult. We present a case of a perforated duodenal ulcer in a RYGBP operated patient, where free abdominal fluid, but hardly any pneumoperitoneum was seen on a computed tomography. Free intraperitoneal fluid is an important finding and should give suspicion of the need for emergency surgery in RYGBP operated patients with abdominal pain.
authors.affiliation: Kirurgisk Afdeling, Hvidovre Hospital, Kettegård Alle 26, 2650 Hvidovre, Denmark. chr.wied@gmail.com
authors.forename: Christian
authors.initials: C
authors.lastname: Wied
authors.forename: Guðny B
authors.initials: GB
authors.lastname: Akralið
authors.forename: Morten Laksáfoss
authors.initials: ML
authors.lastname: Lauritsen
authors.forename: Lars Peter Skat
authors.initials: LP
authors.lastname: Naver
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D001202:Ascitic Fluid / Q000000981:diagnostic imaging; D004381:Duodenal Ulcer / Q000150:complications*; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D010439:Peptic Ulcer Perforation / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed