IBC Oxford University Oral Abstract 12 - Video abstract: a visual concerto: exploring the wide array of bowel obstructions following Roux-en-Y gastric bypass

Abstract Introduction Small bowel obstruction (SBO) is a significant source of morbidity in patients who have undergone Roux-en-Y gastric bypass (RYGB) surgery. In addition to variable anatomic locations, SBO have a wide range of clinical presentations. Delays or inexperience in managing such cases can lead to catastrophic outcomes. Methods Data from chart review and intraoperative recordings were compiled to create a video case series. Results Five representative cases were selected. One case involved the management of an acute SBO secondary to an internal hernia at the Jejunojejunal mesenteric defect. The second case addressed recurrent partial obstructive symptoms caused by internal hernia at the Peterson space. The third case involved a closed-loop SBO secondary to an adhesive band. The fourth case addressed acute small bowel obstruction secondary to intussusception at the Jejunojejunal anastomosis. Finally, the last case discussed the management of a rare case of small bowel obstruction from a food bezoar lodged at the ileocecal valve. Each case had a distinct location and level of complexity requiring different operative approaches. All cases were managed successfully with laparoscopic approach and discharged home safely. Conclusions SBO in RYGB patients has a wide range of complex clinical presentations. Managing such complex cases requires not only timely intervention and understanding of intricate anatomical variances but also the technical skill to achieve resolution.