Fatal complications after an interrupted gastric bypass oper
Obesity is closely linked to non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH), the latter now being the most common cause of cirrhosis in Western countries.

Only a few cases have been described, such as the unexpected death after interrupted obesity surgery in a patient due to inaccurate preoperative imaging assessment.

Doctors describe a 53-year-old male patient with multiple comorbidities partly related to his obesity. A laparoscopic Roux-en-Y gastric bypass (LRYGB) was attempted. During anesthesia, the patient had a cardiac arrhythmia and short asystole. Intra-operative findings indicated a giant spleen and, unexpectedly, a cirrhotic liver. The LRYGB operation was interrupted.

After 19 months, the patient died due to his severe comorbidities. Preoperative imaging missed the diagnosis of liver cirrhosis and related NASH.

Since a challenging liver failure diagnosis cannot only rely on current imaging, researchers suggest that a liver biopsy is performed prior to LRYGB if preoperative imaging indicates cirrhotic liver.

Journal of Surgical Case Reports
Source: https://doi.org/10.1093/jscr/rjab247