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Roux-en-Y partial volvulus in biliary-digestive reconstruction in children.
Carlos García-Hernández1, Joel Cazares-Rangel2, Lourdes Carvajal-Figueroa1
1Departamento de Cirugía Pediátrica, Hospital Infantil Privado, Ciudad De México.
Cirugia Y Cirujanos
|December 14, 2023
Summary
Bowel obstruction, specifically volvulus, can occur years after biliary-digestive bypass surgery. This rare complication involves twisting and tissue death in the digestive loop, causing sudden abdominal pain without liver issues.
Area of Science:
- Gastroenterology
- Surgical Complications
- Abdominal Surgery
Background:
- Biliary-digestive reconstruction is performed to restore continuity between the biliary system and the digestive tract.
- Post-surgical complications are common, but specific issues like loop volvulus are rarely documented.
- Previous literature has not described volvulus of the biliodigestive loop segment.
Purpose of the Study:
- To report a previously undescribed complication following biliary-digestive reconstruction.
- To highlight the occurrence of segment volvulus in the biliodigestive loop years after surgery.
- To describe the clinical presentation of this rare complication.
Main Methods:
- Case report of two patients who underwent biliodigestive bypass.
- Analysis of clinical presentation and diagnostic findings.
- Review of surgical history and follow-up period.
Main Results:
- Two patients developed sudden, severe abdominal pain years after biliodigestive bypass.
- Imaging and surgical exploration revealed volvulus with necrosis of a segment of the biliodigestive loop.
- Patients presented with acute pain but without signs of impaired liver function.
Conclusions:
- Volvulus of a segment of the biliodigestive loop is a rare but serious complication.
- This complication can manifest years after the initial surgical correction.
- Sudden abdominal pain in patients with prior biliary-digestive reconstruction warrants consideration of loop volvulus, even without liver dysfunction.
