Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management
Marginal ulcer (MU) is a potential complication following Roux-en-Y gastric bypass (RYGB), with a mean prevalence of 4.6%. Early identification and prompt intervention are crucial to mitigating further complications. The pathophysiology of MU is complex and involves multiple factors, including smoki...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/13/4336 |
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| author | Marita Salame Noura Jawhar Amanda Belluzzi Mohammad Al-Kordi Andrew C. Storm Barham K. Abu Dayyeh Omar M. Ghanem |
| author_facet | Marita Salame Noura Jawhar Amanda Belluzzi Mohammad Al-Kordi Andrew C. Storm Barham K. Abu Dayyeh Omar M. Ghanem |
| author_sort | Marita Salame |
| collection | DOAJ |
| description | Marginal ulcer (MU) is a potential complication following Roux-en-Y gastric bypass (RYGB), with a mean prevalence of 4.6%. Early identification and prompt intervention are crucial to mitigating further complications. The pathophysiology of MU is complex and involves multiple factors, including smoking, <i>Helicobacter pylori</i> infection, non-steroidal anti-inflammatory drug (NSAID) use, and larger pouch size. Patients with MU may experience acute or chronic abdominal pain. Rarely, they may present with a complication from the ulceration, such as bleeding, perforation, or strictures. Following diagnosis by endoscopy, management of MU typically involves modification of risk factors and medical therapy focused on proton pump inhibitors. In case of complicated ulcers, surgical intervention is often required for the repair of the perforation or resection of the stricture. For recurrent or recalcitrant ulcers, endoscopic coverage of the ulcer bed, resection of the anastomosis, and abdominal or thoracoscopic truncal vagotomy may be considered. This review aims at providing an overview of the etiology, diagnosis, and management of MU after RYGB. |
| first_indexed | 2024-03-11T01:37:24Z |
| format | Article |
| id | doaj.art-aae5028ebca34ab29ad245c98d28a2fc |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T01:37:24Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-aae5028ebca34ab29ad245c98d28a2fc2023-11-18T16:52:25ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011213433610.3390/jcm12134336Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and ManagementMarita Salame0Noura Jawhar1Amanda Belluzzi2Mohammad Al-Kordi3Andrew C. Storm4Barham K. Abu Dayyeh5Omar M. Ghanem6Department of Surgery, Mayo Clinic, Rochester, MN 55905, USADivision of Pediatric Surgery, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA 15224, USADepartment of Surgery, Mayo Clinic, Rochester, MN 55905, USADepartment of Surgery, Mayo Clinic, Rochester, MN 55905, USADepartment of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USADepartment of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USADepartment of Surgery, Mayo Clinic, Rochester, MN 55905, USAMarginal ulcer (MU) is a potential complication following Roux-en-Y gastric bypass (RYGB), with a mean prevalence of 4.6%. Early identification and prompt intervention are crucial to mitigating further complications. The pathophysiology of MU is complex and involves multiple factors, including smoking, <i>Helicobacter pylori</i> infection, non-steroidal anti-inflammatory drug (NSAID) use, and larger pouch size. Patients with MU may experience acute or chronic abdominal pain. Rarely, they may present with a complication from the ulceration, such as bleeding, perforation, or strictures. Following diagnosis by endoscopy, management of MU typically involves modification of risk factors and medical therapy focused on proton pump inhibitors. In case of complicated ulcers, surgical intervention is often required for the repair of the perforation or resection of the stricture. For recurrent or recalcitrant ulcers, endoscopic coverage of the ulcer bed, resection of the anastomosis, and abdominal or thoracoscopic truncal vagotomy may be considered. This review aims at providing an overview of the etiology, diagnosis, and management of MU after RYGB.https://www.mdpi.com/2077-0383/12/13/4336marginal ulcerRoux-en-Y gastric bypassbariatric surgery |
| spellingShingle | Marita Salame Noura Jawhar Amanda Belluzzi Mohammad Al-Kordi Andrew C. Storm Barham K. Abu Dayyeh Omar M. Ghanem Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management Journal of Clinical Medicine marginal ulcer Roux-en-Y gastric bypass bariatric surgery |
| title | Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management |
| title_full | Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management |
| title_fullStr | Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management |
| title_full_unstemmed | Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management |
| title_short | Marginal Ulcers after Roux-en-Y Gastric Bypass: Etiology, Diagnosis, and Management |
| title_sort | marginal ulcers after roux en y gastric bypass etiology diagnosis and management |
| topic | marginal ulcer Roux-en-Y gastric bypass bariatric surgery |
| url | https://www.mdpi.com/2077-0383/12/13/4336 |
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