Surgical Management of Small Intestinal Bacterial Overgrowth After Roux-en-Y Gastric Bypass
| Autor: | Antonio Iannelli, Sébastien Frey, Florent Alcaraz |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Reoperation
medicine.medical_specialty Abdominal pain medicine.drug_class Endocrinology Diabetes and Metabolism medicine.medical_treatment Antibiotics Gastric bypass Gastric Bypass 030209 endocrinology & metabolism 03 medical and health sciences 0302 clinical medicine Small intestinal bacterial overgrowth medicine Humans Adverse effect Nutrition and Dietetics business.industry Anastomosis Roux-en-Y medicine.disease Roux-en-Y anastomosis Pathophysiology Surgery Obesity Morbid Treatment Outcome Jejunostomy 030211 gastroenterology & hepatology Laparoscopy medicine.symptom business |
| Zdroj: | Obesity surgery. 30(11) |
| ISSN: | 1708-0428 |
| Popis: | Small intestinal bacterial overgrowth (SIBO) is a common adverse effect after laparoscopic Roux-en-Y gastric bypass (LRYGB) and may be responsible for chronic diarrhea, abdominal pain, and discomfort. Although its pathophysiology is still unclear, surgical management may be appropriate in selected cases. In this video, we present a surgical revision of LRYGB, 12 years after the initial surgery, for late postoperative chronic diarrhea. The diagnosis of SIBO was finally established and associated with a dilated jejuno-jejunostomy diagnosed through a small bowel follow-through. Revision of the RYGB was performed by resecting the dilated jejunostomy and fashioning a new one with a shorter Roux-en-Y limb. During follow-up, the patient showed fast improvement and complete resolution of symptoms was obtained at 12 months. SIBO may be responsible for postoperative chronic diarrhea in RYGB patients, possibly in the long term, and it is often misdiagnosed. Primary treatment is conservative with appropriate dietary measures, antibiotics, and probiotics but surgical management can be very effective in selected patients presenting with failure of prolonged medical treatment and an anatomic abnormality. |
| Databáze: | OpenAIRE |
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