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2017, Number 3-4

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Rev Mex Cir Endoscop 2017; 18 (3-4)

Roux-in-Y gastro-jejunal bypass rescue after re-weight gaining on a patient with situs inversus totalis. A case report

López CJA, Guzmán CF, Encinas VJR, Orduño FME, Salgado RAS

Language: Spanish
References: 26
Page: 144-148
PDF size: 230.99 Kb.


ABSTRACT

Introduction: Weight regain has been reported from the second year after the most common bariatric procedures (gastric sleeve, gastro-jejunal bypass, and adjustable gastric band) Some surgical options have been described for patients post gastrojejunal bypass with weight regain such as gastric pouch reduction and the gastro-jejunal anastomosis, common loop length shortening, placing a gastric band and currently endoscopic procedures. The association of this problem in patients with situs inversus totalis is extremely rare, it also makes it difficult to approach the re-operation by its inverted anatomy. Case report: This is 47 years female with weight regain after a gastro-jejunal bypass at 10 years post-primary procedure with a 100% weight regain. Currently with a body mass index of 52.3 and the presence of the already known situs inversus totalis. Therefore a protocol was established by reducing the gastric pouch and the gastro-jejunal anastomosis and finally shortening the length of the common canal in order to increase malabsorption. Conclusion: Checking a gastro-jejunal bypass after weight regain, implies a great surgical challenge due to its high comorbidity rate. In this particular case, the technical difficulty is increased by her super-obesity and the situs inversus totalis.


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