Severe Gastric Outlet Obstruction From Gastric Remnant Ulceration and Stricture: A Rare Complication Manifesting 2 Decades After Roux-en-Y Gastric Bypass

Roux-en-Y gastric bypass (RYGB) is a widely performed bariatric procedure that rarely leads to complications involving the remnant stomach. We present the case of severe gastric outlet obstruction caused by ulceration in the remnant stomach 2 decades after RYGB. Multimodal imaging confirmed the diagnosis, with direct visualization achieved via access through a gastrostomy-tube tract. This case highlights the importance of sustained clinical vigilance with the possibility of late-onset complications of RYGB, such as remnant gastric ulcers, which may manifest long after the routine postprocedural follow-up period.