Risk for Small Bowel Obstruction is 'Not Exclusively Specific to Bariatric Surgery'

Gastroenterology QAWith Healio Gastroenterology

On July 13, the LA County medical examiner's office reported that Lisa Marie Presley, singer-songwriter and child of Elvis Presley, died of a small bowel obstruction caused by scar tissue that developed after a previous bariatric surgery.

Most small bowel obstructions are a result of prior surgeries, JAMA reported in 2018, noting "the more surgeries that involve the bowel, the more scars are likely to form." This can lead to a bowel blockage that cuts off blood supply from the small intestine if left untreated.

"In terms of the risk for small bowel obstruction, like any other type of abdominal surgery, there is a risk for scar tissue formation after bariatric surgery," Ali Aminian, MD, director of the Bariatric and Metabolic Institute at Cleveland Clinic, told Healio Gastroenterology. "When there is scar tissue in the abdomen, that scar tissue makes thick bands that can kink or twist the bowel causing external compression, which can lead to small bowel obstruction or blockage."

Aminian also noted diat the risk for small bowel obstruction is "not exclusively specific to bariatric surgery" and can occur after any other abdominal surgery, such as appendectomy or hysterectomy. In the International

Journal of Surgery Case Reports, Vincenzo Pilone, MD, PhD, and colleagues reported that small bowel obstruction after laparoscopic Roux-en-Y gastric bypass occurs at a frequency of 0.2% to 4.5% years or months after surgery.

In a Healio Gastroenterology interview exclusive, Aminian broke down the severity of small bowel obstruction, symptoms patients and providers should watch for, and risks vs. benefits of bariatric surgery.

Q What causes small bowel obstruction?

Aminian: There are...