Gastric Adenocarcinoma Presenting after Revisional Roux-en-Y Gastric Bypass

Gastric mucosal changes have been documented after vertical banded gastroplasty and other restrictive procedures and have been attributed to the mesh involved in the procedure or stasis of intraluminal contents within the gastric pouch.2 RYGB incorporates all of the prior risk factors-pre-existing obesity, chronic foreign body irritation from the staple line-and incorporates a third: bile reflux into the excluded stomach. Because of the possibility of altering management with the findings, preoperative endoscopy prior to bariatric procedures is often recommended.3 In a 2006 study, 169 bariatric-procedure naive patients with planned laparoscopic RYGB underwent esophagogastroduodenoscopy.