Jejunal food bolus obstruction

JEJUNAL FOOD BOLUS OBSTRUCTION

A 60-year-old woman presented with nausea, vomiting, and epigastric pain of several days’ duration. Eleven months earlier, she had undergone laparoscopic gastric bypass surgery for super-morbid obesity (body mass index [50), after which she lost over 100 pounds of body weight. Examination was unremarkable. Upper endoscopy revealed a normal esophagus, gastric pouch, and gastroenteric anastomosis. The jejunal limb was obstructed at 10 to 15 cm distal to the anastomosis by a food bolus caught in a loop of suture material (A). The bolus could be pushed distally about 5 to 10 cm, but it could not be

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GASTROINTESTINAL ENDOSCOPY

freed from the suture that originated from the anastomosis (B). One end of the suture loop was cut with endoscopic scissors (C), whereupon the bolus was released into the jejunal limb (D). Recovery was uneventful, with resolution of the symptoms. Gary Payman, MD Jawad Ahmad, MD Division of Gastroenterology, Hepatology and Nutrition University of Pittsburgh Medical Center Pittsburgh, Pennsylvania PII: S0016-5107(04)02202-3

VOLUME 60, NO. 6, 2004