Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar

Introducción: La obstrucción intestinal por coágulo intraluminal es una complicación posquirúrgica poco frecuente reportada en la literatura. Reportamos el caso de un paciente con obstrucción intestinal por coágulos intraluminales posquirúrgicos de una hepaticoyeyunostomía con Y de Roux. Caso clínic...

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Autores:
Marín Marmolejo, Juan Carlos
Sarmiento, Luis Antonio
Martínez, Juan David
Tipo de recurso:
Article of journal
Fecha de publicación:
2020
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/9893
Acceso en línea:
http://hdl.handle.net/20.500.12749/9893
Palabra clave:
Thrombosis
Small intestine
Intestinal obstruction
Gastrectomy
Postoperative period
Ciencias de la salud
Medicina
Ciencias medicas
Trombosis
Intestino delgado
Obstrucción intestinal
Gastrectomía
Periodo posoperatorio
Rights
License
Derechos de autor 2020 MedUNAB
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dc.title.spa.fl_str_mv Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar
dc.title.translated.eng.fl_str_mv Postoperative intraluminal blood clots after a hepaticojejunostomy: rare, fast-action complication
title Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar
spellingShingle Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar
Thrombosis
Small intestine
Intestinal obstruction
Gastrectomy
Postoperative period
Ciencias de la salud
Medicina
Ciencias medicas
Trombosis
Intestino delgado
Obstrucción intestinal
Gastrectomía
Periodo posoperatorio
title_short Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar
title_full Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar
title_fullStr Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar
title_full_unstemmed Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar
title_sort Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuar
dc.creator.fl_str_mv Marín Marmolejo, Juan Carlos
Sarmiento, Luis Antonio
Martínez, Juan David
dc.contributor.author.spa.fl_str_mv Marín Marmolejo, Juan Carlos
Sarmiento, Luis Antonio
Martínez, Juan David
dc.subject.keywords.eng.fl_str_mv Thrombosis
Small intestine
Intestinal obstruction
Gastrectomy
Postoperative period
topic Thrombosis
Small intestine
Intestinal obstruction
Gastrectomy
Postoperative period
Ciencias de la salud
Medicina
Ciencias medicas
Trombosis
Intestino delgado
Obstrucción intestinal
Gastrectomía
Periodo posoperatorio
dc.subject.lemb.spa.fl_str_mv Ciencias de la salud
Medicina
Ciencias medicas
dc.subject.proposal.spa.fl_str_mv Trombosis
Intestino delgado
Obstrucción intestinal
Gastrectomía
Periodo posoperatorio
description Introducción: La obstrucción intestinal por coágulo intraluminal es una complicación posquirúrgica poco frecuente reportada en la literatura. Reportamos el caso de un paciente con obstrucción intestinal por coágulos intraluminales posquirúrgicos de una hepaticoyeyunostomía con Y de Roux. Caso clínico: Paciente masculino de 53 años de edad, se presenta con cuadro de colangitis recurrente, secundaria a estenosis benigna de la vía biliar post colecistectomía laparoscópica, realizada hace 2 años. En su manejo con endoprótesis por colangiopancreatografía retrógrada endoscópica (CPRE) no mejoró de sus episodios de colangitis, por lo que se consideró el paso a una reconstrucción tipo hepaticoyeyunostomía. En el postoperatorio temprano, presentó signos de obstrucción intestinal. La tomografía computarizada (TC) abdominal contrastada demostró líquido libre y signos de obstrucción. Es llevado a cirugía de urgencia, encontrándose la anastomosis en Y de Roux obstruida por gran coágulo intraluminal, requiriendo enterotomía para su extracción. Discusión: La obstrucción intestinal postoperatoria secundaria a un coágulo intraluminal es inusual, se debe sospechar en paciente con síntomas de obstrucción intestinal. El método ideal para el diagnóstico es la tomografía y el tratamiento es con relaparotomía para extraer los coágulos. Es importante el conocimiento de esta entidad para cualquier médico, ya que es una rara complicación en la que se necesita una buena sospecha diagnóstica y un tratamiento oportuno.
publishDate 2020
dc.date.accessioned.none.fl_str_mv 2020-10-27T14:19:11Z
dc.date.available.none.fl_str_mv 2020-10-27T14:19:11Z
dc.date.issued.none.fl_str_mv 2020-07-22
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/*ref*/Shah MM, Rather AA, Khan FA. Acute Bowel Obstruction After Hepaticojejunostomy Caused by Blood Clots. Journal of the society of laparoendoscopic surgeon. 2014;30(2):1-4. https://doi.org/10.4293/CRSLS.2014.00188 Ohi R, Yaoita S, Kamiyama T, Ibrahim M, Hayashi Y, Chiba T. Surgical treatment of congenital dilatation of the bile duct with special reference to late complications after total excisional op- eration. J Pediatr Surg. 1990;25(1):613-617. https://doi.org/10.1016/0022-3468(90)90346-B Yamataka A, Ohshiro K, Okada Y, et al. Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pedi- atr Surg. 1997; 32(2):1097-1102. https://doi.org/10.1016/S0022-3468(97)90407-3 Lewis CE, Jensen C, Tejirian T, Dutson E, Mehran A. Early jejunojejunostomy obstruction after laparoscopic gastric bypass: case series and treatment algorithm. Surg Obes Relat Dis. 2009;5(2):203-207. https://doi.org/10.1016/j.soard.2008.10.003 Koppman JS, Li C, Gandsas A. Small bowel obstruction after laparoscopic Roux-En-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 2008;206:571-84. https://doi.org/10.1016/j.jamcollsurg.2007.10.00 Pazouki A, Pakaneh M, Khalaj A, Tamannaie Z, Jangjoo A, Shapoori P, et al. Blood bezoar causing obstruction after laparoscopic Roux-en-Y gastric bypass. Int J Surg Case Rep [Internet]. Surgical Associates Ltd. 2014;5(4):183-5. https://doi.org/10.1016/j.ijscr.2013.12.022 Abbas MA, Collins JM, Olden KW, et al. Spontaneous intra-mural small-bowel hematoma: clinical presentation and long-term outcome. Arch Surg. 2002;137:306-310. https://doi.org/10.1001/archsurg.137.3.306 Soricelli E, Facchiano E, Quartararo G, Beltrame B, Leuratti L, Lucchese M. Large Hemobezoar Causing Acute Small Bowel Obstruction After Roux-en-Y Gastric Bypass: Laparoscopic Management. Obes Surg. Obesity Surgery; 2017;27(7):1906-7. https://doi.org/10.1007/s11695-017-2708-4 Felsher J, Brodsky J, Brody F. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Surgery. 2003;134(3):501-505. https://doi.org/10.1067/S0039-6060(03)00251-4 McLaughlan J. Fatal false aneurysmal tumour occupying nearly the whole of the duodenum. Lancet 2. 1838:30(766). https://doi.org/10.1016/S0140-6736(02)95675-8 Homma Y, Mori K, Ohnishi Y, Fujioka K, Terada T, Sasaki A, et al. Ultrasound follow-up in a patient with intestinal obstruction due to post-traumatic intramural duodenal hematoma. J Med Ultrason (2001) [Internet]. 2016 Jul 18 [cited 2018 Apr 26];43(3):431-4. https://doi.org/10.1007/s10396-016-0717-x Chang C-W, Chen M-J, Shih S-C, Wang H-Y, Tsai C-H, Wang T-E, et al. Delayed duodenal intramural hematoma with obstruction. Am J Surg. 2010 Jun [cited 2018 Apr 26];199(6):e77-8. https://doi.org/10.1016/j.amjsurg.2009.07.046 Green J, Ikuine T, Hacker S, Urrego H, Tuggle K. Acute small bowel obstruction due to a large intraluminal blood clot after laparoscopic Roux-en-Y gastric bypass. J Surg Case Reports. 2016;2016(8):rjw143. https://doi.org/10.1093/jscr/rjw143 Peeters G, Gys T, Lafullarde T. Small Bowel Obstruction after Laparoscopic Roux-en-Y Gastric Bypass Caused by an Intraluminal Blood Clot. Obes Surg. 2009 Apr 6;19(4):521-3. https://doi.org/10.1007/s11695-008-9575-y Helling TS, Balliro JM, Nguyen NT, Longoria M, Wilson SE. The lethality of obstructing hematoma at the jejunojejunostomy following Roux-en-Y gastric bypass. Obes Surg. 2005;15(2):290-3. https://doi.org/10.1381/0960892053268318 Awais O, Raftopoulos I, Luketich JD, Courcoulas A. Acute, complete proximal small bowel obstruction after laparoscopic gastric bypass due to intraluminal blood clot formation. Surg Obes Relat Dis. 2005;1(4):418-22. https://doi.org/10.1016/j.soard.2005.04.004 Lim YJ, Nam SH, Kim SJ. Large intraluminal ileal hematoma presenting as small bowel obstruction in a child. Iran J Radiol. 2015 Apr 22;12(2):e8212. https://doi.org/10.5812/iranjradiol.8212 Delibegovic M, Alispahic A, Gazija J, Mehmedovic Z, Mehmedovic M. Intramural Haemorrhage and Haematoma as the Cause of Ileus of the Small Intestine in a Haemophiliac. Med Arch (Sarajevo, Bosnia Herzegovina). 2015 Jun;69(3):206-7. Schroeder RM, Kohler JE, Mak GZ, Kandel JJ. Bowel obstruction from intramural hematoma in two children treated with low molecular weight heparin: Case report and review of the literature. J Pediatr Surg Case Reports [Internet]. 2014;2(10):483-5. https://doi.org/10.1016/j.epsc.2014.09.013 Zammit A, Marguerat DG, Caruana C. Anticoagulation-induced spontaneous intramural small bowel haematomas. BMJ Case Rep [Internet]. 2013 Jun 3;2013:bcr2013008831. https://doi.org/10.1136/bcr-2013-008831 Brar P, Singh I, Kaur S, Doley RP, Brar R, Sahni A, et al. Anticoagulant-induced intramural hematoma of the jejunum. Clin J Gastroenterol [Internet]. 2011 Dec 30 [cited 2018 Apr 26];4(6):387-90. https://doi.org/10.1007/s12328-011-0256-3 Veldt BJ, Haringsma J, Florijn KW, Kuipers EJ. Coumarin-induced intramural hematoma of the duodenum: case report and review of the literature. Scand J Gastroenterol [Internet]. 2011 Mar 14 [cited 2018 Apr 26];46(3):376-9. https://doi.org/10.3109/00365521.2010.531484 Altikaya N, Parlakgümüş A, Demır Ş, Alkan Ö, Yildirim T. Small bowel obstruction caused by intramural hematoma secondary to warfarin therapy: a report of two cases. Turk J Gastroenterol [Internet]. 2011 [cited 2018 Apr 26];22(2):199–202. https://doi.org/10.4318/tjg.2011.0192 Grasshof C, Wolf A, Neuwirth F, Posovszky C. Intramural duodenal haematoma after endoscopic biopsy: case report and review of the literature. Case Rep Gastroenterol [Internet]. 2012 Jan [cited 2018 Apr 26];6(1):5-14. https://doi.org/10.1159/000336022 Wassner JD, Yohai E, Heimlich HJ. Complications associated with the use of gastrointestinal stapling devices. Surgery. 1977;82(4):395-399. Birns MT, Katon RM, Keller F. Intramural hematoma of the small intestine presenting with major upper gastrointestinal hemorrhage. Gastroenterology. 1979;77(2):1094-1100. https://doi.org/10.1016/S0016-5085(79)80084-0 Eiland M, Han SY, Hicks GM. Intramural hemorrhage of the small intestine. JAMA. 1978;239(3):139-142. Shimizu H, Maia M, Kroh M, Schauer PR, Brethauer SA. Surgical management of early small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis [Internet]. 2013 Sep [cited 2018 Apr 26];9(5):718-24. https://doi.org/10.1016/j.soard.2012.05.009 Ruiz-Tovar J. Hemobezoar causante de obstrucción intestinal a nivel del pie de asa durante el postoperatorio de un Bypass Gástrico en Y de Roux. BMI
Bariátrica Metabólica Ibero-Americana [Internet]. 2017 Sep 29 [cited 2018 Apr 26];7(3):1859-1961. Mizumura N, Imagawa A, Kawasaki M, Okumura S, Toyoda S, Ogawa M. Small Bowel Obstruction Caused by Blood Clots: A Rare Complication of Peptic Ulcer. J Med Cases [Internet]. 2015;6(10):477-9. https://doi.org/10.14740/jmc2298w Siddiky A, Gupta P. Proximal small bowel obstruction caused by a massive intraluminal thrombus from a stress ulcer. J Surg case reports [Internet]. 2012 Jan 1 [cited 2018 Apr 26];2012(1):6. https://doi.org/10.1093/jscr/2012.1.6 Onda M, Urazumi K, Abe R, Matsuo K. Obstructive Ileus caused by blood clot after emergency total gastrectomy in a patient with hemophilia A: report of a case. Surg Today [Internet]. 1998 [cited 2018 Apr 26];28(12):1266-9. https://doi.org/10.1007/BF02482812
dc.relation.uri.none.fl_str_mv https://revistas.unab.edu.co/index.php/medunab/article/view/3823
dc.relation.references.spa.fl_str_mv Shah MM, Rather AA, Khan FA. Acute Bowel Obstruction After Hepaticojejunostomy Caused by Blood Clots. Journal of the society of laparoendoscopic surgeon. 2014;30(2):1-4. https://doi.org/10.4293/CRSLS.2014.00188
Ohi R, Yaoita S, Kamiyama T, Ibrahim M, Hayashi Y, Chiba T. Surgical treatment of congenital dilatation of the bile duct with special reference to late complications after total excisional op- eration. J Pediatr Surg. 1990;25(1):613-617. https://doi.org/10.1016/0022-3468(90)90346-B
Yamataka A, Ohshiro K, Okada Y, et al. Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pedi- atr Surg. 1997; 32(2):1097-1102. https://doi.org/10.1016/S0022-3468(97)90407-3
Lewis CE, Jensen C, Tejirian T, Dutson E, Mehran A. Early jejunojejunostomy obstruction after laparoscopic gastric bypass: case series and treatment algorithm. Surg Obes Relat Dis. 2009;5(2):203-207. https://doi.org/10.1016/j.soard.2008.10.003
Koppman JS, Li C, Gandsas A. Small bowel obstruction after laparoscopic Roux-En-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 2008;206:571-84. https://doi.org/10.1016/j.jamcollsurg.2007.10.00
Pazouki A, Pakaneh M, Khalaj A, Tamannaie Z, Jangjoo A, Shapoori P, et al. Blood bezoar causing obstruction after laparoscopic Roux-en-Y gastric bypass. Int J Surg Case Rep [Internet]. Surgical Associates Ltd. 2014;5(4):183-5. https://doi.org/10.1016/j.ijscr.2013.12.022
Abbas MA, Collins JM, Olden KW, et al. Spontaneous intra-mural small-bowel hematoma: clinical presentation and long-term outcome. Arch Surg. 2002;137:306-310. https://doi.org/10.1001/archsurg.137.3.306
Soricelli E, Facchiano E, Quartararo G, Beltrame B, Leuratti L, Lucchese M. Large Hemobezoar Causing Acute Small Bowel Obstruction After Roux-en-Y Gastric Bypass: Laparoscopic Management. Obes Surg. Obesity Surgery; 2017;27(7):1906-7. https://doi.org/10.1007/s11695-017-2708-4
Felsher J, Brodsky J, Brody F. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Surgery. 2003;134(3):501-505. https://doi.org/10.1067/S0039-6060(03)00251-4
McLaughlan J. Fatal false aneurysmal tumour occupying nearly the whole of the duodenum. Lancet 2. 1838:30(766). https://doi.org/10.1016/S0140-6736(02)95675-8
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dc.publisher.none.fl_str_mv Universidad Autónoma de Bucaramanga UNAB
dc.publisher.faculty.spa.fl_str_mv Facultad Ciencias de la Salud
dc.publisher.program.spa.fl_str_mv Pregrado Medicina
publisher.none.fl_str_mv Universidad Autónoma de Bucaramanga UNAB
dc.source.none.fl_str_mv MedUNAB; Vol. 23 Núm. 2 (2020): agosto - noviembre 2020: Cirugía general, Coronavirus, Hemorroides; 294-300
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spelling Marín Marmolejo, Juan Carlos3ccd7cf0-7f7e-442c-9fe3-5f0739597cd1-1Sarmiento, Luis Antonio25205430-b93e-422e-a706-a1e78be041e7-1Martínez, Juan Davidf4dd4452-281a-4244-bde5-d6c38ab94d30-12020-10-27T14:19:11Z2020-10-27T14:19:11Z2020-07-222382-46030123-7047http://hdl.handle.net/20.500.12749/9893instname:Universidad Autónoma de Bucaramanga UNABrepourl:https://repository.unab.edu.co10.29375/01237047.3823Introducción: La obstrucción intestinal por coágulo intraluminal es una complicación posquirúrgica poco frecuente reportada en la literatura. Reportamos el caso de un paciente con obstrucción intestinal por coágulos intraluminales posquirúrgicos de una hepaticoyeyunostomía con Y de Roux. Caso clínico: Paciente masculino de 53 años de edad, se presenta con cuadro de colangitis recurrente, secundaria a estenosis benigna de la vía biliar post colecistectomía laparoscópica, realizada hace 2 años. En su manejo con endoprótesis por colangiopancreatografía retrógrada endoscópica (CPRE) no mejoró de sus episodios de colangitis, por lo que se consideró el paso a una reconstrucción tipo hepaticoyeyunostomía. En el postoperatorio temprano, presentó signos de obstrucción intestinal. La tomografía computarizada (TC) abdominal contrastada demostró líquido libre y signos de obstrucción. Es llevado a cirugía de urgencia, encontrándose la anastomosis en Y de Roux obstruida por gran coágulo intraluminal, requiriendo enterotomía para su extracción. Discusión: La obstrucción intestinal postoperatoria secundaria a un coágulo intraluminal es inusual, se debe sospechar en paciente con síntomas de obstrucción intestinal. El método ideal para el diagnóstico es la tomografía y el tratamiento es con relaparotomía para extraer los coágulos. Es importante el conocimiento de esta entidad para cualquier médico, ya que es una rara complicación en la que se necesita una buena sospecha diagnóstica y un tratamiento oportuno.Introduction: An intestinal obstruction due to intraluminal blood clots is a postoperative complication that is infrequently reported in literature. We reported the case of a patient with an intestinal obstruction due to postoperative intraluminal blood clots from a Roux-en-Y hepaticojejunostomy. Clinical Case: A 53-year-old male patient appeared with recurring cholangitis secondary to a benign stenosis of the bile duct after a laparoscopic cholecystectomy performed 2 years prior. Treatment with an endoprosthesis by endoscopic retrograde cholangiopancreatography (ERCP) did not improve cholangitis episodes, for which reason transition to reconstruction by hepaticojejunostomy was considered. He showed signs of intestinal obstruction during early postoperative care. The computed tomography (CT) scan of the abdomen with contrast showed free fluid and signs of obstruction. The patient was taken to an emergency surgery, where the Roux-en-Y anastomosis was found to be obstructed by a large intraluminal blood clot. It required an enterotomy to be extracted. Discussion: A postoperative intestinal obstruction secondary to intraluminal blood clots is unusual, but must be suspected in patients with symptoms of intestinal obstruction. The ideal method for diagnosis is by tomography and treatment involves a relaparotomy to extract the blood clots. It is important for doctors to have knowledge of this condition, since it is a rare complication that requires good diagnostic insight and timely treatment.application/pdfText/xmlspaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludPregrado Medicinahttps://revistas.unab.edu.co/index.php/medunab/article/view/3823/3289Https://revistas.unab.edu.co/index.php/medunab/article/view/3823/3302/*ref*/Shah MM, Rather AA, Khan FA. Acute Bowel Obstruction After Hepaticojejunostomy Caused by Blood Clots. Journal of the society of laparoendoscopic surgeon. 2014;30(2):1-4. https://doi.org/10.4293/CRSLS.2014.00188 Ohi R, Yaoita S, Kamiyama T, Ibrahim M, Hayashi Y, Chiba T. Surgical treatment of congenital dilatation of the bile duct with special reference to late complications after total excisional op- eration. J Pediatr Surg. 1990;25(1):613-617. https://doi.org/10.1016/0022-3468(90)90346-B Yamataka A, Ohshiro K, Okada Y, et al. Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pedi- atr Surg. 1997; 32(2):1097-1102. https://doi.org/10.1016/S0022-3468(97)90407-3 Lewis CE, Jensen C, Tejirian T, Dutson E, Mehran A. Early jejunojejunostomy obstruction after laparoscopic gastric bypass: case series and treatment algorithm. Surg Obes Relat Dis. 2009;5(2):203-207. https://doi.org/10.1016/j.soard.2008.10.003 Koppman JS, Li C, Gandsas A. Small bowel obstruction after laparoscopic Roux-En-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 2008;206:571-84. https://doi.org/10.1016/j.jamcollsurg.2007.10.00 Pazouki A, Pakaneh M, Khalaj A, Tamannaie Z, Jangjoo A, Shapoori P, et al. Blood bezoar causing obstruction after laparoscopic Roux-en-Y gastric bypass. Int J Surg Case Rep [Internet]. Surgical Associates Ltd. 2014;5(4):183-5. https://doi.org/10.1016/j.ijscr.2013.12.022 Abbas MA, Collins JM, Olden KW, et al. 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Surg Today [Internet]. 1998 [cited 2018 Apr 26];28(12):1266-9. https://doi.org/10.1007/BF02482812https://revistas.unab.edu.co/index.php/medunab/article/view/3823Shah MM, Rather AA, Khan FA. Acute Bowel Obstruction After Hepaticojejunostomy Caused by Blood Clots. Journal of the society of laparoendoscopic surgeon. 2014;30(2):1-4. https://doi.org/10.4293/CRSLS.2014.00188Ohi R, Yaoita S, Kamiyama T, Ibrahim M, Hayashi Y, Chiba T. Surgical treatment of congenital dilatation of the bile duct with special reference to late complications after total excisional op- eration. J Pediatr Surg. 1990;25(1):613-617. https://doi.org/10.1016/0022-3468(90)90346-BYamataka A, Ohshiro K, Okada Y, et al. Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults. J Pedi- atr Surg. 1997; 32(2):1097-1102. https://doi.org/10.1016/S0022-3468(97)90407-3Lewis CE, Jensen C, Tejirian T, Dutson E, Mehran A. Early jejunojejunostomy obstruction after laparoscopic gastric bypass: case series and treatment algorithm. Surg Obes Relat Dis. 2009;5(2):203-207. https://doi.org/10.1016/j.soard.2008.10.003Koppman JS, Li C, Gandsas A. Small bowel obstruction after laparoscopic Roux-En-Y gastric bypass: a review of 9,527 patients. J Am Coll Surg. 2008;206:571-84. https://doi.org/10.1016/j.jamcollsurg.2007.10.00Pazouki A, Pakaneh M, Khalaj A, Tamannaie Z, Jangjoo A, Shapoori P, et al. Blood bezoar causing obstruction after laparoscopic Roux-en-Y gastric bypass. Int J Surg Case Rep [Internet]. Surgical Associates Ltd. 2014;5(4):183-5. https://doi.org/10.1016/j.ijscr.2013.12.022Abbas MA, Collins JM, Olden KW, et al. Spontaneous intra-mural small-bowel hematoma: clinical presentation and long-term outcome. Arch Surg. 2002;137:306-310. https://doi.org/10.1001/archsurg.137.3.306Soricelli E, Facchiano E, Quartararo G, Beltrame B, Leuratti L, Lucchese M. Large Hemobezoar Causing Acute Small Bowel Obstruction After Roux-en-Y Gastric Bypass: Laparoscopic Management. Obes Surg. Obesity Surgery; 2017;27(7):1906-7. https://doi.org/10.1007/s11695-017-2708-4Felsher J, Brodsky J, Brody F. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Surgery. 2003;134(3):501-505. https://doi.org/10.1067/S0039-6060(03)00251-4McLaughlan J. Fatal false aneurysmal tumour occupying nearly the whole of the duodenum. Lancet 2. 1838:30(766). https://doi.org/10.1016/S0140-6736(02)95675-8Derechos de autor 2020 MedUNABhttp://creativecommons.org/licenses/by-nc/4.0/http://creativecommons.org/licenses/by-nc-nd/2.5/co/Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2MedUNAB; Vol. 23 Núm. 2 (2020): agosto - noviembre 2020: Cirugía general, Coronavirus, Hemorroides; 294-300Coágulos intraluminales en postoperatorio de una hepaticoyeyunostomía: rara complicación para un rápido actuarPostoperative intraluminal blood clots after a hepaticojejunostomy: rare, fast-action complicationinfo:eu-repo/semantics/articleArtículohttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/redcol/resource_type/ARThttp://purl.org/coar/version/c_970fb48d4fbd8a85ThrombosisSmall intestineIntestinal obstructionGastrectomyPostoperative periodCiencias de la saludMedicinaCiencias medicasTrombosisIntestino delgadoObstrucción intestinalGastrectomíaPeriodo posoperatorioORIGINAL2020_Coágulos_intraluminales.pdf2020_Coágulos_intraluminales.pdfArticuloapplication/pdf770445https://repository.unab.edu.co/bitstream/20.500.12749/9893/1/2020_Co%c3%a1gulos_intraluminales.pdfcbebfad8e018e192eef82afb4199278cMD51open accessTHUMBNAIL2020_Coágulos_intraluminales.pdf.jpg2020_Coágulos_intraluminales.pdf.jpgIM Thumbnailimage/jpeg11717https://repository.unab.edu.co/bitstream/20.500.12749/9893/2/2020_Co%c3%a1gulos_intraluminales.pdf.jpgaeb957fe99270802ac5bee6ed74578bbMD52open access20.500.12749/9893oai:repository.unab.edu.co:20.500.12749/98932023-10-17 22:01:33.489open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.co

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