Bariatric Times

MAY 2016

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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C l i n i c a l D e v e l o p m e n t s a n d M e t a b o l i c I n s i g h t s i n T o t a l B a r i a t r i c P a t i e n t C a r e Volume 13, Number 5 May 2016 A P e e r - R e v i e w e d P u b l i c a t i o n W W W . B A R I A T R I C T I M E S . C O M LIKE us on Facebook • FOLLOW us on Twitter • CONNECT with us on LinkedIn Presorted Standard U.S. Postage PAID Lebanon Junction, KY Permit #344 DOWNLOAD OR UPDATE THE BARIATRIC TIMES APP TODAY! EDITORIAL MESSAGES ...............3 Guest Editorial from Dr. Scott Shikora: V agal Blocking T herapy: A Safe, Reversible, C ompatible Option for Treating O besity A Message from Dr. Christopher Still: Nonalcoholic Fatty Liver Disease: An Under Diagnosed, Growing Epidemic that Deserves Our Attention A Message from Tracy Martinez: The Department of Integrated Health Continuing Education: Addressing Total Bariatric Patient Care, Helping You Fulfill CEUs Also Inside NEWS AND TRENDS . ... ... .. ... .. ... 20 SYMPOSIUM PREVIEW ... .. ... .. ... 26 IFSO 2016: 21st World Congress of the International Federation for the Surgery of Obesity & Metabolic Disorders Rio de Janeiro, Brazil ITunes Google (Android) Download the BT app for your mobile device! Scan this QR code with your QR reader for the digital edition of Bariatric Times. CALENDAR OF EVENTS ................30 MARKETPLACE ...........................30 AD INDEX ....................................31 Page 16 CASE REPORT Page 10 COLUMN EDITOR Daniel B. Jones, MD, MS, FASMBS FEATURED STUDENT Ofer Fass, BS, BHS Obesity and Gastroesophageal Reflux Disease (GERD) INTRODUCTION Obesity is a highly challenging disorder to our healthcare system that continues to increase in frequency and severity. It has been estimated that greater than one third of American adults (34.9% or 78.6 million people) are classified as having obesity, which is defined as a body mass index (BMI) of 30kg/m 2 or more. 1 It is predicted that by the year 2030, the rate of obesity among the general population will surpass 44 percent in all 50 states of the United States. 2 Obesity also poses a substantial financial burden in the United States, with an estimated annual medical cost of $147 billion in 2008 alone. 3 Similarly, gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder affecting approximately 20 percent of the adult population in the United States, and it has been growing in prevalence. 4,5 T h e M E D I C A L S T U D E N T N o t e b o o k An Unusual Late Complication following Open Undivided Roux- en-Y Gastric Bypass by WASEF ABU-JAISH, MD, FACS; TRISTAN MCKNIGHT, MS-III; and CONOR O'NEILL, MD INTRODUCTION L ap aroscop i c R ou x-en -Y gast ri c byp ass ( R Y GB ) was t h e most common bariatric procedure performed in the United States from 2004 to 2012, after which sleeve gastrectomy (SG) became the most common procedure. 1 Complications of RYGB are not uncommon, and the evaluation for gastrointestinal symptoms and abdominal pain can be difficult. Nausea, vomiting, and abdominal pain are common complaints following RYGB, with late complications most commonly due to internal hernias or small bowel obstruction etiologies. 2 Internal hernias have been described in 0 to 5 percent of p at i en t s u n d ergoi n g l ap aroscop i c bari at ri c su rgery an d are wel l con t rol l ed by cl osi n g al l p ot en t i al i n t ern al h ern i a defects. 3 However, internal hernias can be intermittent and, therefore, difficult to detect radiographically. Other causes of obstructive symptoms can be herniation at port sites, strictures at the jejunojejunal anastomosis, intussusception, and, especially in open cases, adhesions. Here, we present a case of a patient who experienced nausea, vomiting, severe left upper quadrant abdominal pain, and shortness of breath 18 years following an open undivided RYGB. Lysis of adhesions.

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