RESUMO
INTRODUCTION: Adjustable gastric banding (AGB) used to be a popular bariatric procedure. However, it fails in more than half of those operated on in the long term, becomes ineffective and must be removed. Therefore, the use of AGB has been in decline globally. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most used bariatric revision surgeries when AGB is removed. CASE REPORT: We present the case of a woman after AGB removal and conversion to SG who developed a stenosis of the sleeve. Therefore, a decision was made to convert to RYGB with a good effect. CONCLUSION: Revisional procedures are more technically challenging than primary procedures and have higher complication rates. The most performed revisional operations include SG and RYGB. Stenosis of the sleeve can occur after SG, with a negative impact on the patient's nutritional status and quality of life. This can be managed by endoscopic dilatation, and where this solution proves ineffective, RYGB can be indicated.
Assuntos
Derivação Gástrica , Gastroplastia , Obesidade Mórbida , Feminino , Humanos , Derivação Gástrica/efeitos adversos , Derivação Gástrica/métodos , Obesidade Mórbida/cirurgia , Gastroplastia/efeitos adversos , Gastroplastia/métodos , Constrição Patológica/cirurgia , Qualidade de Vida , Reoperação/métodos , Gastrectomia/métodos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The incidence of explosions in large agglomerations is high even during peacetime and continues rising. Blast syndrome injuries are complex, with shock wave causing severe injuries of multiple organ systems. In situations with large numbers of injured persons, effective triage allows an early diagnosis and treatment of the highest number of victims. Treatment is challenging, and potentially conflicting therapeutic goals may alternate. This review provides an overview of the pathophysiology of blast injuries, current diagnostic algorithms and therapeutic procedures.
