A gastric ulcer at the anastomosis site perforated into the liver 3 years after Roux-en-Y gastric bypass surgery.

摘要

A 44-year-old woman underwent gastric bypass surgery in 2004. One year later, she began to complain of intermittent melena associated with nausea and right upper quadrant (RUQ) pain, which required 1 to 2 units of packed red blood cell transfusions per year. In July 2007, she presented to the emergency department with 2 episodes of bright red blood per rectum associated with syncope. Upper endoscopy was performed and revealed a large ulcer at the anastomosis site, with a visible bleeding vessel, which was cauterized.