Small Bowel Bypass as Treatment for Functional Gastric Obstruction

Multiple bariatric operations performed on the same patient can cause loss of normal peristaltic function of the stomach. Bariatric revisions, especially when combined with previous truncal vagotomy, can lead to functional gastric obstruction. These patients complain of severe nausea and intractable vomiting. This can cause excessive weight loss and malnutrition, requiring at times total parenteral nutrition (TPN) or forms of enteral feeding. These patients frequently require a total or subtotal gastric resection with an esophago-jejunal anastomosis to relieve symptoms. We present two patients with a functional gastric obstruction treated by a small bowel bypass, which successfully relieved all symptoms of obstruction and allowed normal food intake.