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SAGES 2026 Annual Meeting Emerging Technology Session
March 25-28, 2026 | Tampa, FL, USA
P265
Spectrum of Jejunal Injury and Anastomotic Leakage After Bariatric Bypass Procedures: Modes of Injury, Clinical Presentations, and Management Outcomes
Poster Presenter
Authors
Affiliations
Part of Topic
Bariatric
Background
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Bariatric bypass procedures, while highly effective, carry risks of serious complications, including jejunal injury and anastomotic leakage.
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These complications can be life-threatening and often present with a diverse and sometimes subtle array of clinical and radiographic signs.
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We aim to illustrate the spectrum of these injuries through a case series, highlighting varied presentations and the critical need for prompt diagnosis.
Methods
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A retrospective case series of patients who underwent bariatric bypass procedures and subsequentlydeveloped jejunal or anastomotic complications.
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Clinical records, operative reports, and radiographic imaging (CT scans) were reviewed to identify modes of injury and management outcomes.
Case presentation
Case 1: Subtle Presentation(Figure 1)
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Symptoms: Mild lower abdominal pain on POD 2 accompanied by isolated tachycardia (HR 100).
Radiology: CT scan shows subtle omental stranding in the lower abdomen with small, localized fluid collections. No contrast extravasation is observed. -
Case 2: Acute Presentation (Figure 2)
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Symptoms: Acute abdomen with high fever and tachycardia on POD 5.
Radiology: CT scan reveals a moderate fluid collection with clear contrast extravasation at the enteroentericanastomosis. -
Case 3: Immediate Presentation (Figure 3)
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Observation: Mild upper abdominal pain on POD 1, followed by an increase in the output of the surgical drain.
Radiology: CT scan shows contrast extravasation from the gastrojejunostomy.
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High Index of Suspicion:
Clinical symptoms like tachycardia and fever in post-bariatric patients must be treated as a potential leak until proven otherwise.
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Radiographic Nuance:
Do not rely solely on "frank" signs of perforation; subtle findings like localized stranding on CT require aggressive investigation.
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Vigilance Beyond the Immediate Period:
Complications can occur at varying postoperative intervals, requiring long-term clinical awareness.
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Prompt Management:
Early recognition is the cornerstone of preventing life-threatening outcomes in this high-risk population.