Obesity Surgery Can Lead to ER Trip Years Later

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October 8, 2007, 3:04 pm
Obesity Surgery Can Lead to ER Trip Years Later
Posted by Jacob Goldstein

As the number of Americans getting gastric bypass surgery to lose weight has climbed, so has the number of people showing up at emergency rooms with complications months or years afterward.

The problem that’s sending many patients for emergency care is internal hernias, according to a study being presented today at the annual scientific meeting of the American College of Emergency Physicians in Seattle.

Surgeons who perform gastric bypasses are plenty familiar with the problem — the study abstract says it shows up in about 5% of patients. (In a conversation with the Health Blog the study’s author, Stephen Scott, put the rate a bit lower.)

But because the hernias may not cause a problem until years after the surgery, patients may show up at an emergency room complaining of pain or nausea without suspecting the source of the problem. The diagnosis may also be tough for an ER doc to make on the fly.

“A lot of ER doctors have not seen a lot of bariatric patients,” said Scott, a bariatric surgeon at the University of Missouri. As a result, “Sometimes patients have had to wait for a while for something where [a bariatric surgeon] would have said, ‘It’s probably this.’ ”

The study mined the records of two surgeons to find patients who had bariatric surgery, went to the ER at some point after the procedure, and and ultimately wound up getting a second, follow-up surgery to correct a problem.

Of those patients, some 64% had either a hernia or a mesenteric defect, the gap in internal tissue that can lead to a hernia. On average, patients showed up at the ER nearly two years after their initial surgery.

“Primary care doctors and emergency room doctors need more education about these types of patients because they’re going to be seeing more and more of them,” Scott said.

肥胖手术若干年后也许会进急诊室
10月8日报道：随着通过胃分流术减肥的美国人人数的增多，数月或数年后因此并发症出现在急诊室的人显现出来。