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[Perforated duodenal ulcer after laparoscopic Roux-en-Y gastric bypass].
Elisabeth Desirée Kjærsgaard1, Kathrine Holte1
1Mave- og Tarmkirurgisk Afdeling, Regionshospital Nordjylland.
Ugeskrift for Laeger
|March 24, 2026
Summary
A perforated duodenal ulcer in the gastric remnant after Roux-en-Y gastric bypass is rare but serious. Early intervention is crucial, as standard imaging may not detect free air due to absorption in the gastric remnant.
Area of Science:
- Gastroenterology
- Surgical Case Reports
- Abdominal Surgery
Background:
- Roux-en-Y gastric bypass is a common bariatric procedure.
- Complications can arise, including gastrointestinal perforations.
- Perforated duodenal ulcers in the gastric remnant are a rare but critical complication.
Purpose of the Study:
- To report a case of perforated duodenal ulcer in the gastric remnant following Roux-en-Y gastric bypass.
- To highlight diagnostic challenges associated with this condition.
- To emphasize the importance of early clinical suspicion and intervention.
Main Methods:
- Case report of a 55-year-old female patient.
- Review of clinical presentation, diagnostic imaging (CT scan), and management.
- Discussion of diagnostic limitations in patients with prior gastric bypass.
Main Results:
- The patient presented with a perforated duodenal ulcer in the gastric remnant.
- Computed tomography (CT) scan did not reveal free air, a common finding in perforated viscus, due to air absorption in the gastric remnant.
- The diagnosis was challenging due to atypical imaging findings.
Conclusions:
- Perforated duodenal ulcers in the gastric remnant post-Roux-en-Y gastric bypass require high clinical suspicion.
- Diagnostic imaging limitations necessitate a low threshold for surgical intervention.
- Increased awareness among clinicians is vital for timely diagnosis and management of this rare complication.
