Acute gastric remnant dilation after laparoscopic Roux-en-Y gastric bypass operation in long-standing type I diabetic patient: Case report and literature review.

Acute gastric remnant dilation is a rare postoperative complication of laparoscopic Roux-en-Y gastric bypass (LRYGB) occurring in 0–0.8% of cases [1–7]. It is usually associated with jejunojejunostomy obstruction or gastric remnant ulcer formation. The typical presenting symptoms include left upper quadrant abdominal pain, hiccups, and persistent tachycardia. It is managed by gastrostomy tube decompression, and relief of distal obstruction. Delayed diagnosis may lead to gastric remnant perforation, organ failure, sepsis, and death. We encountered 1 case of acute gastric remnant dilation in a young patient with type 1 diabetes mellitus after an uneventful laparoscopic LRYGB. This complication was not associated with concomitant jejunojejunostomy stricture or distal bowel obstruction. The patient denied having any autonomic neuropathy or symptoms of gastroparesis preoperatively. However, she was later found to have severe hypomotility of the gastric remnant. To our knowledge, this is the first reported case of isolated gastric remnant dilation after LRYGB in the English literature.