BACKGROUND: @entity548 from the excluded gastric segment or duodenum after gastric bypass is an uncommon late complication and poses both diagnostic and therapeutic difficulties. We describe 4 cases of late @entity360 after gastric bypass. METHODS: 4 @entity1 who underwent previous Roux-en-Y gastric bypass (RYGBP) presented for management of severe @entity360 . Their history, diagnostic work-up, management, and surgical pathology are reviewed. RESULTS: In all 4 @entity1 , preoperative diagnostic evaluation including nuclear scintigraphy, endoscopy, and angiography failed to localize the source of @entity548 . Intraoperative endoscopy of the gastric remnant and subtotal gastrectomy were performed in all 4 @entity1 . The mean time interval between RYGBP operation and gastrectomy was 15.5 years (range 13-17 years). In 3 of 4 @entity1 , the source of @entity548 was documented on pathologic examination of the resected gastric remnant and duodenum. At a mean follow-up of 15 months, none of the @entity1 developed recurrent @entity360 . CONCLUSION: @entity360 after RYGBP can be a diagnostic and therapeutic dilemma. Intraoperative endoscopy of the excluded stomach and subtotal gastrectomy should be considered when the source of @entity548 is not identified by conventional diagnostic techniques.

Late XXXX after gastric bypass.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity360 :: ('MESH:D006471', 'Disease') :: ['gastrointestinal (GI) hemorrhage', 'GI hemorrhage'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding', 'Hemorrhage']
@entity360 :: (MESH:D006471,Disease) :: ['gastrointestinal hemorrhage']
