Roux-en-Y gastric bypass

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Schematic showing a Roux-en-Y gastric bypass. (Lina Wolf/WC)

Roux-en-Y gastric bypass is procedure used to treat obesity.

General

  • Treatment for obesity.
  • Mortality ~0.15%.[1]
  • A segment of small bowel is excised as part of the procedure.

Microscopic

Features:

  • Normal small bowel wall.

Note:

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Small Bowel, Excision During Gastric Bypass:
     - Small bowel wall within normal limits. 
Small Bowel, Excision during Roux-en-Y Gastric Bypass:
- Small bowel wall within normal limits. 

IELs present

Small Bowel, Excision during Gastric Bypass:
	- Small bowel wall with increased intraepithelial lymphocytes, otherwise within normal limits, see comment.

Comment:
The increased intraepithelial lymphocytes are likely explained by obesity; however, other causes (such as infection, inflammatory bowel disease and celiac disease) should be considered within the clinical context. 

See also

References

  1. Benotti, P.; Wood, GC.; Winegar, DA.; Petrick, AT.; Still, CD.; Argyropoulos, G.; Gerhard, GS. (Jan 2014). "Risk factors associated with mortality after Roux-en-Y gastric bypass surgery.". Ann Surg 259 (1): 123-30. doi:10.1097/SLA.0b013e31828a0ee4. PMID 23470583.
  2. Harpaz, N.; Levi, GS.; Yurovitsky, A.; Kini, S. (Mar 2007). "Intraepithelial lymphocytosis in architecturally normal small intestinal mucosa: association with morbid obesity.". Arch Pathol Lab Med 131 (3): 344; author reply 344. doi:10.1043/1543-2165(2007)131[344b:IR]2.0.CO;2. PMID 17516730.