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Image of the Month—Quiz Case
Kevin Cho, BA;
Collin E. M. Brathwaite, MD;
Arif Ahmad, MD
From the School of Medicine, State University of New York at Stony Brook (Mr Cho); and the Department of Surgery, Stony Brook University Hospital (Drs Brathwaite and Ahmad), New York, NY.
Arch Surg. 2003;138:455.
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INTRODUCTION
A 38-YEAR-OLD white woman with a height of 167.6 cm and weight of 136.1 kg (body mass index, 48 [calculated as weight in kilograms divided by height in meters squared]) underwent laparoscopic Roux-en-Y gastric bypass (RYGBP) for morbid obesity. Comorbidities included dyslipidemia, osteoarthritis, urinary stress incontinence, and depression. Preoperative testing included endoscopy, which demonstrated grade III esophagitis. No gallstones were evident on abdominal ultrasound.
Laparoscopic RYGBP gastric bypass was performed without complications, and the patient's recovery was uneventful until postoperative day 2, when she developed sudden abdominal pain. An upper gastrointestinal series with oral contrast is shown in Figure 1. Although she remained afebrile and her urine output was adequate, she became tachycardic (120-130 beats/min) and complained of generalized abdominal pain. A computed tomographic scan of the abdomen with oral and intravenous contrast is shown in Figure 2. . . [Full Text of this Article]
What Is the Diagnosis?
RELATED ARTICLE
Image of the Month—Diagnosis
Arch Surg. 2003;138(4):456.
EXTRACT
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