Ulceration in the bariatric patient

Abstract

Marginal ulceration is a common complication following Roux-en-Y gastric bypass surgery. These ulcers usually occur at the gastrojejunal anastomosis and can cause significant morbidity, resulting in multiple readmissions. The incidence seems to vary widely depending on the surgical technique, and theories about marginal ulcer etiology are abundant, including excess acid, fistula formation, ischemia, bile reflux, foreign body reactions, inflammation, and H. pylori infection. Long-term medical treatment with sucralfate suspension and acid inhibitors seems to heal ulcers in most patients. Additionally, revision surgery has been performed for recalcitrant ulcer disease with variable success.