Hematemesis Case Study

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In our study, intraoperative complications occurred in only 1 (2.7%) patient in the form of liver tear which was managed by compression. On the other hand, in open RYGB Luján et al. (27) reported 3 (6%) cases of splenic injuries that leaded to splenectomies while in open classical D.S, Hess and Hess (13) reported splenic injury and splenectomy in 4 (0.9%) patients
In our study, Hematemesis occurred only in 1(2.7%) non compliant patient due to stomal ulceration following administration of intravenous acetyle salicylic acid. Gastric bleeding reported in 1 (1%) patient after loop D.S by Sánchez-Pernaute et al. (17), in 4 (0.5%) Patients after open classical D.S by Biertho et al. (28) and in 1 (0.6%) patient after open BPD by Gracia et
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Both of them had with BMI ≥ 60 kg/m2, android built , sleep apnea syndrome and were previously treated from venous stasis disease; these are high risk factors for developing DVT (32-33) . In the series of open classical D.S , Hess and Hess (13) reported 3 (0.75%) cases of DVT and 2 (0.5%) cases of non fatal pulmonary embolism. Marceau et al. (35) reported DVT and PE in 9 (3.6%) patients. According to Podnos at al. (36), deep vein thrombosis after laparoscopic RYGB with thromboprophylaxis ranged from 0% to 1.3%, pulmonary embolism ranged from 0% to 1.1%. We recorded 1 (2.7%) case of mortality due to pulmonary embolism. Hess and Hess (13) reported also one (0.25%) case of fatal pulmonary embolism. Postoperative follow up revealed 2 (5.4%) cases that developed gallstones in the first year after surgery that required cholecystectomy. In a study on open classical D.S by Abd El-Razik et al. (25) he reported 1 (2.5%) case who developed cholilithiasis that needed cholycystectomy. Bowel obstruction was not reported in our study during the follow up period. Bowel obstruction by internal herniation was reported in 8 ( 2%) patients by Hess and Hess (13) after open classical DS and 3 (2.8 %) patients by Luján et al. (27) after Laparoscopic RYGB. As was stated before, SADI-S has no mesentric …show more content…
It was detected that the entire lipid profile consisting of total cholesterol, LDL, TG, and HDL had a statistically significant improvement one year after surgery. The mean total cholesterol decreased significantly from 277.15±59.57mg/dl to 143.41±18.15 mg/dl (P < 0.001), the mean LDL decreased significantly from 168.27±50.07mg/dl to 98.23±37.13mg/dl (P < 0.001), the mean TG decreased significantly from 177.83±15.23 mg/dl to 102.31±13.54 mg/dl (P < 0.001), and the mean HDL increased significantly from 34.35±6.70 mg/dl to 44.89±4.59 mg/dl (P < 0.001) during this time period. Our results were higher than those reported by Prachand et al. (41) after RYGB and Sudan and Jacobs (39) after DS who stated that the rate of resolution of dyslipidemia occurred in 26.3% and 72% of patients respectively. Our results regarding the resolution of hypertriglyceridemia were the same as those of Scopinaro et al. (30)

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