Blood bezoar causing obstruction after laparoscopic Roux-en-Y gastric bypass

Bowel obstruction is a known complication after bariatric surgery especially Roux-en-Y gastric bypass. The known etiologies include internal hernia, jejunojejunostomy stricture, ileus, intussusceptions, superior mesenteric artery syndrome, incarcerated port site hernia, and adhesions. Blood bezoar is a rare cause of small intestinal obstruction after Roux-en-Y gastric bypass.

We are going to present two cases of small bowel obstruction after Roux-en-Y gastric bypass due to blood bezoar.

Blood clot as the etiology of small bowel obstruction after Roux-en-Y gastric bypass is an unusual event. In the presence of postoperative small intestinal obstruction an obstructive blood bezoar should be in differential diagnosis. As any other etiology of postoperative obstruction it should be treated immediately to prevent its adverse lethal complications.

The best way for prevention of blood bezoar is prevention of bleeding at staple line and doing hemostasis at stapler line.