Case 20-2008: A 57-Year-Old Woman with Abdominal Pain and Weakness after Gastric Bypass Surgery

摘要

Dr. Allyson K. Bloom (Medicine): A 57-year-old woman was admitted to this hospital because of abdominal pain and weakness. One month earlier, a laparoscopic Roux-en-Y gastric bypass and cholecystectomy were performed for treatment of obesity and gallstones. Pathological examination of a liver-biopsy specimen revealed nonalcoholic fatty liver disease. The immediate postoperative course was uncomplicated, and she was discharged 2 days after surgery. At follow-up visits, she reported poor oral intake, episodes of tachycardia (which had occurred intermittently in the past), intermittent passage of watery stool and dark urine, and suprapubic and epigastric pain; on two occasions, fluids were administered intravenously in the emergency department or clinic. Eighteen days before this admission, she returned to the emergency department with diffuse, crampy abdominal pain and was admitted to the surgical service.