Work

Biliopancreatic limb obstruction secondary to 9 cm gallstone nearly two decades following open Roux-en-Y gastric bypass and cholecystectomy: a rare and challenging case

Year: 2025

Type: article

Abstract: Gallstone ileus is a rare complication of chronic cholelithiasis and an exceedingly uncommon cause of bowel obstruction following Roux-en-Y gastric bypass (RYGB), particularly after cholecystectomy. We report the first known case of a large gallstone causing obstruction of the biliopancreatic limb in an 80-year-old woman with prior RYGB, cholecystectomy, and choledochoduodenostomy. She underwent successful open enterolithotomy with stone extraction. This case highlights the diagnostic and technical challenges posed by altered post-RYGB anatomy and emphasizes the importance of maintaining a high index of suspicion in similar presentations. Early recognition and individualized operative management are critical to achieving favorable outcomes in this rare but potentially life-threatening condition.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf968

Authors: Elisabeth Barrar, Christian M Simon, Husain Abbas

Institutions: Atrium Health Wake Forest Baptist, Wake Forest University, HCA Florida Orange Park Hospital, Memorial Hospital

Language: English

Topic: Biliary and Gastrointestinal Fistulas

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000