A case of a bulging oesophageal bypass
|Photo: NEJM 2016.|
22 April 2016
Doctors have reported the case of a man who developed a hernia through the opening created for his oesophagogastric bypass.
The 60-year-old man visited a clinic with concerns regarding the cosmetic results of the bypass he had had 53 years earlier.
When he was a child, an alkali burn resulting in complete narrowing of his oesophagus (gullet) necessitated the surgery, which was performed by means of colonic interposition, where the colon is used to replace the oesophagus.
“Historically, the subcutaneous (under the skin) route for oesophagogastric bypass was chosen — as in our patient — to avoid additional complications of surgery and anaesthesia” said the case report authors from the University of Freiburg in Germany.
The subcutaneous tunnel created a bulging outline of the patient’s intestines — a cosmetic side effect of the surgery.
On physical examination, the doctors discovered the herniation of the proximal jejunum, but a water-swallowing test (see video) revealed normal swallowing function.
“Currently, colonic interposition, as well as subcutaneous positioning of the oesophageal substitute, is rarely performed,” they wrote in the New England Journal of Medicine.
After discussing the risks of an operation, the man declined surgery to repair the hernia.
Last Reviewed: 22/04/2016
Coronary artery bypass surgery
The aim of coronary artery bypass surgery is to bypass blocked coronary arteries and improve blood flow to the heart muscle. This can relieve angina and help prevent heart attacks.
Weight loss surgery linked to drinking problems
Research suggests that one particular type of bariatric surgery is linked to people having a much higher chance of developing a drinking problem down the track.
Gastric bypass better than gastric banding for inducing remission in diabetes
People with type 2 diabetes undergoing bariatric surgery are considerably more likely to experience remission with a Roux-en-Y gastric bypass (RYGBP), compared with gastric banding.
Neck pain: treatment
Treatment for neck pain depends on the cause and how severe it is. Neck pain treatment, including treatment for whiplash, often involves a combination of self-care, medicines, exercises and relaxation therapies.
Weight loss surgery
There are several types of weight loss surgery – also known as bariatric surgery. Weight loss surgery can help you lose 50 per cent or more of your excess weight in 2 years.