CBC Bariatric Surgery and Procedures 3 — Questions and Answers
Question 1: Two weeks after gastric bypass, a patient reports dizziness, sweating, and cramping shortly after eating a sugary dessert. What is the most likely cause?
- Early dumping syndrome (Correct answer)
- Anastomotic leak
- Internal hernia
- Marginal ulcer
Correct answer: Early dumping syndrome
Early dumping syndrome occurs 15-30 minutes after eating high-sugar foods when hyperosmolar contents rapidly enter the small intestine.
Question 2: Which postoperative complication after bariatric surgery is a life-threatening emergency typically presenting with tachycardia, fever, and abdominal pain in the first week?
- Anastomotic or staple-line leak (Correct answer)
- Dumping syndrome
- Hair loss
- Lactose intolerance
Correct answer: Anastomotic or staple-line leak
A leak from the anastomosis or staple line allows gastric contents into the abdomen, and persistent tachycardia is often the earliest sign.
Question 3: A gastric bypass patient develops burning epigastric pain and is found to have an ulcer at the connection between the pouch and small intestine. Which behavior most increases this risk?
- Smoking and NSAID use (Correct answer)
- Drinking water between meals
- Eating slowly and chewing thoroughly
- Taking daily multivitamins
Correct answer: Smoking and NSAID use
Marginal ulcers at the gastrojejunal anastomosis are strongly associated with smoking and NSAID use, both of which impair mucosal healing.
Question 4: Years after Roux-en-Y gastric bypass, a patient presents with intermittent severe abdominal pain. Which delayed surgical complication should the counselor recognize as unique to bypass anatomy?
- Internal hernia through a mesenteric defect (Correct answer)
- Gallbladder polyps
- Hiatal hernia
- Appendicitis
Correct answer: Internal hernia through a mesenteric defect
Rerouted bowel in Roux-en-Y anatomy creates mesenteric defects through which intestine can herniate and twist, sometimes years later.
Question 5: Which complication is most specifically associated with adjustable gastric banding?
- Band slippage or erosion into the stomach (Correct answer)
- Dumping syndrome
- Severe protein malnutrition
- Bile reflux gastritis
Correct answer: Band slippage or erosion into the stomach
Gastric bands can slip out of position or erode through the stomach wall, which are leading reasons for band removal.
Question 6: A sleeve gastrectomy patient reports new or worsening heartburn after surgery. Why is this a recognized issue with this procedure?
- The high-pressure sleeve can worsen or cause gastroesophageal reflux (Correct answer)
- The sleeve removes the esophageal sphincter
- Bile is rerouted directly into the esophagus
- The procedure always causes hiatal hernia
Correct answer: The high-pressure sleeve can worsen or cause gastroesophageal reflux
The narrow, high-pressure sleeve can increase reflux, and severe GERD may require conversion to gastric bypass.
Question 7: Why does rapid weight loss after bariatric surgery increase the risk of gallstones?
- Rapid fat mobilization increases cholesterol saturation of bile (Correct answer)
- The gallbladder is always removed during surgery
- Bile production stops after surgery
- Vitamin supplementation dissolves gallstones
Correct answer: Rapid fat mobilization increases cholesterol saturation of bile
Rapid weight loss raises cholesterol concentration in bile and reduces gallbladder motility, promoting stone formation.
CBC Bariatric Surgery and Procedures 3
Two weeks after gastric bypass, a patient reports dizziness, sweating, and cramping shortly after eating a sugary dessert.
What is the most likely cause?