A potential complication of bi-level positive airway pressure after gastric bypass surgery

Bi-level positive airway pressure (BIPAP) is a common treatment modality for patients with obstructive sleep apnea (OSA), especially in the morbidly obese population. To our knowledge, there have been no reports of any adverse effects of BIPAP on patients who undergo weight loss surgical procedures. We report 2 patients who were treated with BIPAP in the postoperative period following open Roux-en-Y gastric bypass (RYGBP). Their clinical courses and outcomes are presented. The patients developed massive bowel distention following treatment with BIPAP and subsequently developed anastomotic leaks. BIPAP following RYGBP may not be a completely benign treatment modality. We advise caution and careful monitoring during the use of BIPAP after gastric bypass surgery.