Common weight loss procedures and their complications

Maria S Altieri, Brian Wright, Andrew Peredo, Aurora D Pryor
American Journal of Emergency Medicine 2018, 36 (3): 475-479

BACKGROUND: As the number of obese patients in the United States continues to grow, there is a parallel increase in the number of bariatric surgery patients. A quarter of these patients will return to the Emergency Department (ED) within the first two years of the index procedure.

OBJECTIVE: An understanding of the most common bariatric procedures and their related complications will greatly aide the Emergency Medicine physician in the care of these patients.

DISCUSSION: Abdominal pain is the most common reason for bariatric patients to present to the ED and can represent a diagnostic challenge to EM physicians. It is important that EM physicians have a good understanding of bariatric procedures. We describe the three most common bariatric procedures: 1) the Laparoscopic Adjustable Gastric Banding (LAGB); 2) the Laparoscopic Sleeve Gastrectomy (LSG); 3) and the Roux-en-Y Gastric Bypass (RYGB). Due to the unique altered anatomy following the procedures there are specific complications related to each individual procedure. We will describe the most common presentations of abdominal pain in the post bariatric surgery patient. Finally, we will review new endoscopic procedures and the associated complications that may cause patients to present to the ED.

CONCLUSION: Certain complications in bariatric surgery patients can have a high rate of morbidity and mortality. An improved understanding of bariatric procedures and their complications will allow for improved vigilance and management.

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