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CC BY 4.0 · Journal of Digestive Endoscopy
DOI: 10.1055/s-0045-1811524
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A 4-Year-Old Post-Bariatric Surgery Suture-Bezoar

Authors

  • Fatemeh Askari Bashkani 

    1   Shahid Beheshti University of Medical Science, Tehran, Iran

  • Habib Malekpour

    2   Department of Gastroenterology and Hepatology, Imam Hossein Hospital of Tehran, Shahid Beheshti University of Medical Science, Tehran, Iran
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Case Presentation

A 48-year-old woman who had undergone a Roux-en-Y Gastric Bypass surgery 6 years ago presented to our clinic with a history of recurrent episodes of nausea, nonbilious vomiting, and abdominal pain that began 4 years ago and worsened in the last month. The symptoms were not exacerbated by meals or changes in position. Neither symptoms of headache nor vertigo were told. Prior to this, our patient visited clinicians for her complaints and had undergone multiple endoscopies, which only showed grade A gastroesophageal reflux and no physical obstruction was found. The most recent endoscopy also revealed contamination with Helicobacter pylori. Our patient had received appropriate medications for both problems. Upon her physical examination, only epigastric tenderness was noted. Laboratory tests and imaging showed a grade 2 fatty liver, but were otherwise normal. Motility tests, such as a gastric emptying scan, were not performed for the patient due to the limited availability of specialized clinical centers and the potential cost associated with the procedure. A decision was made to perform an endoscopy, during which a 40-mm bezoar was discovered attached to a nylon suture in the efferent loop of the bypass ([Fig. 1A–C]). After preparing for the procedure, the bezoar was removed endoscopically, first by cutting it with a snare and then retrieving the remaining suture and bezoar through multiple attempts until it was completely removed ([Fig. 1D]). In the follow-up after 4 months, the patient was in complete relief and no adverse event after gastroscopy was appeared.

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Fig. 1 (A) Gastric bezoar extended from the suture in anastomosis in the efferent jejunal loop; the suture has acted as a nidus to trap undigested materials. (B) Extended suture in the efferent jejunal loop. (C) The 40-mm trapped suture-bezoar had made a partial obstruction in the jejunal loop. (D) Complete removal of 40-mm suture-bezoar; symptoms relieved after the procedure and the patient experienced no adverse effect.

Authors' Contributions

Conception and design, critical revision of the article for important intellectual content, and final approval of the article: H.M. Collection of data and drafting of the article: F.A.B. All authors approved the final version of the manuscript and agree to be accountable for all aspects of this work.


Ethical Approval

All human studies have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its subsequent amendments.




Publikationsverlauf

Artikel online veröffentlicht:
08. September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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