Bile aspiration during emergent revision of a single-anastomosis gastric (SASI) bypass to a Roux-en-Y configuration with transit bipartition: a case report.

Authors

María Emilia Salgado, Carolina Guevara, Gabriel Carvajal, Gabriela Zapata Jaramillo, Napoleón Salgado Macías

Published in

Journal of surgical case reports. Volume 2026. Issue 9. Pages rjag786. Epub Sep 02, 2026.

Abstract

Single anastomosis sleeve ileal (SASI) bypass is an emerging bariatric procedure; some patients face complications such as severe bile reflux, requiring conversion. In this context, the surgical goal is to substantially reduce exposure of the stomach and gastroesophageal junction to bile acids to prevent early complications. We present a 46-year-old man with class III obesity (body mass index 54.6 kg/m²) who 10 days after an uneventful SASI bypass, developed intense, persistent, refractory reflux. A diagnostic endoscopy revealed an extensive accumulation of biliary reflux in the gastric lumen, prompting reintervention. During anesthetic induction, the patient aspirated bile, causing acute respiratory distress. After intraoperative stabilization, the team proceeded without further incident, converting the single-loop configuration to a Roux-en-Y transit bipartition, resolving gastroesophageal reflux disease (GERD). This case underscores the need to incorporate prevention maneuvers during anesthetic induction in patients with severe GERD to avoid aspiration, and the importance of anticipating high anesthetic risk in these individuals.

PMID:
42689228
Bibliographic data and abstract were imported from PubMed on 03 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.