Perforated duodenal ulcer after gastric bypass: a challenging diagnosis

Maria J. Amaral, Marco Serôdio, Emília C. Fraga, Cristina P. Camacho, Ana C. Almeida, António Manso, José G. Tralhão


Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed surgeries for morbid obesity. Perforated duodenal ulcers are very rare in these patients (with a 0.25% incidence reported) and the diagnosis can be challenging. We report a case of a 43-year-old woman who presented with severe acute abdominal pain to the emergency department. She had undergone a laparoscopic RYGB 5 years previously. Exploratory laparoscopy revealed a duodenal perforation, which was repaired by primary closure. As Helicobacter pylori has been implicated in the formation of ulcers in this population, eradication therapy should be started.


Gastric bypass, Duodenal ulcer, Perforation, Remnant stomach, Laparoscopy

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