Department of Surgery, Harlem Hospital Center, Columbia University, New York, New York, USA (all authors).

ABSTRACT

Introduction: Gastric bypass is a commonly performed surgery for morbid obesity. Duodenal ulcer perforation after laparoscopic Roux-en-Y gastric bypass is a rare occurrence, with approximately 25 cases reported in the literature. The diagnosis of a perforated duodenal ulcer after gastric bypass can present a challenge. Most peptic ulcers after gastric bypass surgery occur in the Roux limb as marginal ulcers with the symptom of acute epigastric pain. Ulceration and then subsequent perforation in the secretory limb can also present with acute abdominal pain, with or without free air in the peritoneal cavity on imaging studies.

Case Description:We report 2 rare cases of laparoscopic repair of a perforated duodenal ulcer after gastric bypass surgery, treated laparoscopically with a Graham patch.

Conclusions: Diagnostic laparoscopy is recommended for post–Roux-en-Y gastric bypass patients presenting with acute abdominal symptoms, to rule out internal hernias and other rare life-threatening diseases, such as perforated duodenal ulcer. Surgeons should be aware of this entity and be certain to rule it out. If found during exploration, the duodenal ulcer can be repaired with a laparoscopic Graham patch.

Key Words: Abdominal pain, Graham patch repair, Laparoscopic gastric bypass, Perforated duodenal ulcer.

The post Role of Laparoscopy for the Diagnosis and Treatment of Perforated Duodenal Ulcers After Gastric Bypass Surgery first appeared on JSLS.

Department of Obstetrics and Gynecology, and Reproductive Sciences, University of California San Francisco, CA (Drs. Ho, Lager). Northern California Chapter of the American College of Surgeons, and Division of General and Trauma Surgery, Marin General Hospital, Larkspur, CA (Dr. Maa). Department of Surgery, Columbia University, New York, NY (Dr. Liou).

ABSTRACT

The female hydrocele, also known as the canal of Nuck cyst, is a rare congenital abnormality that is the equivalent of the patent processus vaginalis in males. We are the first to report the laparoscopic excision of an entirely extraperitoneal canal of Nuck cyst. We discuss the embryology, pathophysiology, and surgical management of this atypical variant of a rare entity.

Key Words: Canal of Nuck cyst, Hydrocele, Laparoscopic surgery, Processus vaginalis.

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The post Laparoscopic Management of a Canal of Nuck Cyst first appeared on JSLS.