Perforated Peptic Ulcer of the Duodenum After the Laparoscopic Roux-en-Y Gastric Bypass.

This article focuses on the rare complication of perforated ulcers in the gastric remnant and duodenum following laparoscopic Roux-en-Y gastric bypass (LRYGB). It presents the case of a 38-year-old male who developed a perforated duodenal ulcer nearly a year after LRYGB, likely triggered by naproxen use, and was successfully treated with laparoscopic repair using an omental patch. The diagnosis of such ulcers can be challenging due to vague symptoms and often normal imaging, emphasizing the need for a high index of suspicion and early surgical intervention. The article also discusses the limited consensus on postoperative proton pump inhibitor (PPI) use for ulcer prevention, noting benefits primarily in patients with Helicobacter pylori colonization. Patient education and careful postoperative management are highlighted as essential components of care after LRYGB.