Surgical Management of a Caustic Ingestion in a Gastric Bypass Patient: A Case Report

Abstract

Introduction: Bariatric surgery is recognized as the most effective treatment for obesity. Increased rate of psychological disorders has been noted after surgery. However, no case of caustic ingestion after bariatric surgery and its surgical management has been reported in the literature. Presentation of Case: A 48-year-old woman, who underwent a Rouxen- Y gastric bypass 9 years ago, ingested caustic substances as a suicide attempt, causing necrosis of the entire alimentary limb without severe lesion of esophageal tract or gastric pouch. During exploratory laparotomy, resection of the alimentary limb and gastrostomy in the neogastric pouch were performed. Three months later, the patient presented to the emergency room with a dislodged gastrostomy tube. Exploratory laparotomy was performed with restoration of anatomical continuity via gastro-gastric anastomosis. Discussion: Bariatric surgery is correlated to a higher postoperative risk of psychological disorders until suicide attempt. This case is the first description of caustic ingestion after Roux-en-Y gastric bypass and its surgical management. It underlines the importance for bariatric teams to consider psychological aspect of surgical patients pre- and postoperatively.