Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass presenting as acute pancreatitis: a case report

Small bowel obstruction is a common and potentially life-threatening complication after laparoscopic Roux-en-Y gastric bypass surgery. We describe a 30-year-old woman who previously underwent gastric bypass surgery. She was admitted to the emergency department with epigastric pain and elevated serum lipase levels. Conservative treatment was started for acute pancreatitis, but she showed rapid clinical deterioration due to uncontrollable pain and frequent excessive vomiting. An abdominal computed tomography scan revealed small bowel obstruction and surgeons performed an exploratory laparotomy with adhesiolysis. Our patient quickly improved after surgery and could be discharged home. This case report emphasises that in post-bypass patients with elevated pancreatic enzymes, small bowel obstruction should be considered and early computed tomography scan is required in these patients.