GASTROENTEROLOGY ARTICLE OF THE WEEK
March 11, 2010
Obstein KL, Thompson CC. Endoscopy after bariatric surgery. Gastointest Endosc 2009;70:1161-1166
1. Stomal ulcers
a. Usually develop years after the procedure
b. May be caused by H. pylori, ischemia, NSAID or fistula
c. Can be treated with sucralfate capsules
d. If PPI’s are used, should use a soluble PPI
True or False
2. Gastrojejunal anastomosis constructed with a circular staple have a much higher incidence of stenosis than hand-sewn or linear staplers.
3. The presence of erosive esophagitis after RYGB should raise the possibility of gastro-gastric fistula formation
4. Endoscopic dilation of gastrojejunal anastomosis should be restricted to 12mm to prevent weight gain.
5. After gastric bypass, H. pylori antigen test is the best way of establishing the diagnosis of H. pylori infection
6. Sutures associated with an ulcer should be removed endoscopically.
7. Adjustable band gastroplasty is associated with a significant risk of reflux esophagitis, and may require conversion to RYGB