Errant and unrecognized antiperistaltic Roux limb construction during Roux-en-Y gastric bypass for clinically significant obesity

Lana G. Nelson, Michael G. Sarr, Michel M. Murr

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Proper isoperistaltic orientation of the Roux limb is important. We report on 5 patients with errant anatomic construction of the Roux limb during Roux-en-Y gastric bypass for clinically significant obesity. Methods: We performed a retrospective review of the medical records of these 5 patients. Of the 5 patients, 3 had undergone open and 2 laparoscopic Roux-en-Y gastric bypass. Results: These 5 patients developed persistent and predominantly bilious vomiting in the immediate postoperative period, with subsequent protein-calorie malnutrition. At least 18 operations were undertaken in these 5 patients at different times to correct the abnormally dilated Roux limb to no avail. The diagnosis of an antiperistaltic anatomy was unsuspected, and these operations failed to address the errant anatomy of the Roux limb or resolve the symptoms. Definitive treatment involved repositioning of the Roux limb in an isoperistaltic direction, which resulted in immediate resolution of the symptoms and reversal of the protein-calorie malnutrition. Conclusion: Antiperistaltic Roux anatomy is deleterious, and repositioning of the Roux limb in an isoperistaltic direction will resolve the symptoms and associated protein-calorie malnutrition.

Original languageEnglish (US)
Pages (from-to)523-527
Number of pages5
JournalSurgery for Obesity and Related Diseases
Volume2
Issue number5
DOIs
StatePublished - Sep 2006

Fingerprint

Antidiarrheals
Gastric Bypass
Extremities
Obesity
Protein-Energy Malnutrition
Anatomy
Postoperative Period
Vomiting
Medical Records

Keywords

  • Anatomically incorrect
  • Antiperistaltic
  • Complications
  • Errant anatomy
  • Morbid obesity
  • Revisional bariatric surgery
  • Roux-en-Y gastric bypass

ASJC Scopus subject areas

  • Surgery

Cite this

Errant and unrecognized antiperistaltic Roux limb construction during Roux-en-Y gastric bypass for clinically significant obesity. / Nelson, Lana G.; Sarr, Michael G.; Murr, Michel M.

In: Surgery for Obesity and Related Diseases, Vol. 2, No. 5, 09.2006, p. 523-527.

Research output: Contribution to journalArticle

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AB - Background: Proper isoperistaltic orientation of the Roux limb is important. We report on 5 patients with errant anatomic construction of the Roux limb during Roux-en-Y gastric bypass for clinically significant obesity. Methods: We performed a retrospective review of the medical records of these 5 patients. Of the 5 patients, 3 had undergone open and 2 laparoscopic Roux-en-Y gastric bypass. Results: These 5 patients developed persistent and predominantly bilious vomiting in the immediate postoperative period, with subsequent protein-calorie malnutrition. At least 18 operations were undertaken in these 5 patients at different times to correct the abnormally dilated Roux limb to no avail. The diagnosis of an antiperistaltic anatomy was unsuspected, and these operations failed to address the errant anatomy of the Roux limb or resolve the symptoms. Definitive treatment involved repositioning of the Roux limb in an isoperistaltic direction, which resulted in immediate resolution of the symptoms and reversal of the protein-calorie malnutrition. Conclusion: Antiperistaltic Roux anatomy is deleterious, and repositioning of the Roux limb in an isoperistaltic direction will resolve the symptoms and associated protein-calorie malnutrition.

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