A case report on pulmonary aspiration of bilious gastric content in patients with previous one anastomosis – mini gastric bypass: a new risk factor to be incorporated in airway management guidelines?

Mini gastric-bypass or one-anastomosis mini gastric-bypass (OA-MGB) is an emerging surgical technique for weight loss surgery with a single anastomosis and similar weight loss results to a Roux-en-Y gastric bypass (RY-GB). Reflux of bile secretions into the newly formed gastric pouch is a recognised consequence of the OA-MGB. We report a case of severe pulmonary aspiration of bile contents upon induction of anaesthesia for a planned laparoscopic cholecystectomy in a patient with a previous OA-MGB. Airway practice may need to be amended to reflect the specially increased risk of aspiration in patients who have had an OA-MGB.