Gastric Bypass Surgery Causes Bowel Ischemia

Case Overview

This case takes place in Maryland and involves a male patient who underwent a laparoscopic gastric bypass performed by the defendant. The operative note appears to be without incident and no complications were noted. Post-operatively, the patient complained of severe abdominal pain after taking pain medications. The surgeon on call was notified and she was given additional pain medications, but the patient continued to complain of elevated pain throughout the night. The surgeon on call was again notified and additional pain medications were ordered. The next morning, the defendant requested imaging of the patient’s abdomen be performed, at which point a bowel obstruction was identified. The Defendant returned the patient to the operating room, where he was diagnosed with an ischemic bowel. The surgeon documented that patient had an extremely short small intestine. The patient continues to suffer from intra-abdominal infections and has experienced a severely diminished quality of life.

Questions to the General Surgery expert and their responses

Do you have extensive experience performing Roux-en-Y gastric bypass surgery?

I am a fellowship-trained bariatric surgeon, and I regularly perform Roux-en-Y gastric bypass surgery.

What steps should be taken after patient complains of extreme pain and hypertension post surgery?

Pain in the setting of hypertension should be carefully examined, and appropriate imaging studies as well as laboratory evaluations are necessary to determine the cause of the pain.

Are you familiar with the necessary steps when patient complains of the above symptoms?

We are a tertiary center and we do take care of patients with similar issues from other institutions.

About the expert

This expert is a board certified general surgeon who earned his BS and MD from UC Davis. He completed internship training at UCSF, residency training at UCSF, and fellowship training in minimally invasive and bariatric surgery at Johns Hopkins Medical Institution. This expert is a member of numerous prestigious societies in the surgical field, most notably as a fellow in the American College of Surgeons. He is currently an Assistant Professor of surgery, Director of the Comprehensive Hernia Center, and an Associate Medical Director at one of the world's top university medical centers.