Small Bowel Obstruction due to Hemobezoar Following Roux-En-Y Gastric Bypass: A Case Report

Roux-en-Y Gastric Bypass (RYGB) is a widely performed bariatric surgery with well-documented benefits, but it can lead to rare complications such as small bowel obstruction (SBO). While internal hernias and adhesions are common causes, hemobezoar formation is an extremely rare etiology. We report two cases of acute SBO due to hemobezoar following laparoscopic RYGB. Both patients presented with severe nausea within the early postoperative period. CT imaging revealed marked small bowel distension in both cases, prompting surgical intervention. Diagnostic laparoscopy confirmed the presence of obstructing hemobezoars at the jejunojejunostomy site, requiring evacuation and revision of the anastomosis. Both patients had an uneventful postoperative recovery. The formation of hemobezoar after RYGB is rare but should be considered in patients with unexplained early postoperative obstruction. Prompt imaging and laparoscopic intervention are crucial to preventing morbidity.