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Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Page 57
JOINT EVENT
Pediatric Gastro 2018
Digestive Diseases 2018
October 22-23, 2018
October 22-23, 2018 Berlin, Germany
3
rd
International Conference on
Digestive and Metabolic Diseases
Pediatric Gastroenterology Hepatology & Nutrition
13
th
International Conference on
&
Bleeding after gastric bypass surgery. The possibility of using balloon enteroscopy in the postoperative
period
Solovyeva M O
The Federal State Budgetary Institute The Nikiforov Russian Center of Emergency and Radiation Medicine, Saint-Petersburg, Russia
One of the possible complications after bariatric surgery is bleeding. In the majority of cases bleeding in the later stages of
the postoperative period are intraluminal, with clinical manifestations of high gastrointestinal bleeding. Among all bariatric
procedures, the development of this complication is more common after Roux-en-Y gastric bypass. Upper endoscopy is the
diagnostic and treatment method of choice, but only bleeding in the gastric pouch or in the gastroenteroanastomosis can be
stopped in this way. If localization of bleeding is in the remnant stomach or duodenum and small intestine, it is necessary
to use more advanced endoscopic procedures. Male patient, 44 years old with BMI 43 kg/m2 and comorbidities (Diabetes
Mellitus type 2, decompensated in patient receiving hypoglycemic drugs), was undergone laparoscopic Roux-en-Y gastric
bypass in October 2014. During the year %EWL was 81%, there was compensation of diabetes without medication (HbA1
4,9%). In January 2015 he was hospitalized in a clinic in St. Petersburg with signs of upper gastrointestinal bleeding. He has
a history of melena during the last 5 days with an episode of syncope in the hospital day. Hemoglobin was 88 g/l. Upper
endoscopy and colonoscopy were performed without identification of source of bleeding. Drug therapy was conducted. A
few days later the patient was transferred to our hospital with no signs of ongoing bleeding. Balloon-assisted enteroscopy was
performed. Duodenal ulcer with no signs of bleeding was visualized. Endoscopic hemostasis wasn’t needed. The patient was
discharged the next day. Course of anti-ulcer therapy performed. During follow-up there was no recurrence of bleeding.
Conclusions. The use of a balloon-assisted enteroscopy is possible to identify the unidentified sources of bleeding by upper
endoscopy. This method allows viewing distal small intestine and all parts excluded of gastrointestinal digestion. It also allows
performing therapeutic measures if necessary.
mar-sol@mail.ruJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C7-083