Does Gastric Bypass Cause Peritonitis?

Posted on Sat, 11 Oct 2014

Question: Hey Dr. XXXXXXX I have a serious question. My brother died fromperitonitis, volvulus of small intestine performation, peritoneal adhesions, would this occur from his 2000 surgery he had a bypass to loose weight, not the lapband, the other where they cut u. He was 55 and had his whole life ahead of him. A genetic scientist making 150,000 a year. Your opinion. Plaease

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Brief Answer:
Abdominal complications can occur anytime...

Detailed Answer:
Hi

Thanks for posting the query. Please accept my sincerest condolences at the death of your dear brother. I'll make an honest attempt to help you with this query.

The two most commonly performed bariatric operations are, Roux-en-Y Gastric bypass and adjustable gastric banding.

Gastric bypass patients are at risk for small-bowel obstruction secondary to adhesions, internal hernias, intussusception and volvulus. This is commonly noticed in Roux-en-Y procedure.

The Ischemic changes (death of the tissue due to devoid of blood to that particular site) following anastomoses can cause internal hernia, followed by intestinal obstruction and volvulus. The dilated portion can thus rupture causing peritonitis and abdominal infection. If the leak is small, the peritoneum surrounding the intestine tries to seal off the leak. Repeated assault can cause adhesions, volvulus, electrolyte imbalance, etc.

Given the alteration of Gastrointestinal anatomy after bariatric surgery, diagnosis of small bowel obstruction may be delayed and obscured by vague symptoms.

These sort of complications are usually seen years after the actual surgery has been done. Hence, anyone can become a victim of these rare complications by the time appropriate diagnosis is made.

Hope I have answered your query; I'll be available for the follow up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Above answer was peer-reviewed by : Dr. Vaishalee Punj