{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T16:47:11Z","timestamp":1761324431091,"version":"3.41.2"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T00:00:00Z","timestamp":1648339200000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We present a rare case of a jejunal ulcer perforation in the alimentary limb ~15\u00a0cm distal to the gastro-jejunal anastomosis on the background of a previous Roux-en-Y gastric bypass (RYGB) 4 months prior to presentation. Marginal ulcer is the most common cause of jejunal perforation following RYGB. However, this is usually confined to the first few centimetres, and the incidence is highest within the first month following surgery. Other risk factors include smoking and non-steroidal anti-inflammatory drug use, Helicobacter pylori infection, trauma, foreign body ingestion, Crohn\u2019s disease, typhoid, tuberculosis and malignancy. This case does not possess any of these risk factors and thus represents a unique presentation. Not all jejunal ulcers will present with classical risks factors but still will need to be excluded, given their life-threatening nature. Also, the whole alimentary limb can be susceptible to ulceration; therefore, a thorough investigation of this limb is important to exclude perforation.<\/jats:p>","DOI":"10.1093\/jscr\/rjac112","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T04:12:01Z","timestamp":1646712721000},"source":"Crossref","is-referenced-by-count":2,"title":["Non-marginal jejunal ulcer perforation following Roux-en-Y gastric bypass"],"prefix":"10.1093","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0932-5667","authenticated-orcid":false,"given":"Luke D","family":"Fairweather","sequence":"first","affiliation":[{"name":"Department of General Surgery, Western Health, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toan D","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Western Health, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,3,26]]},"reference":[{"key":"2022032913494980300_ref1","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1038\/ajg.2017.241","article-title":"Complications of bariatric surgery: what you can expect to see in your GI practice","volume":"112","author":"Schulman","year":"2017","journal-title":"Am J Gastroenterol"},{"key":"2022032913494980300_ref2","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1590\/S0004-28032010000200003","article-title":"Early marginal ulcer following Roux-en-Y gastric bypass under proton pump inhibitor treatment: prospective multicentric study","volume":"47","author":"Garrido","year":"2010","journal-title":"Arq Gastroenterol"},{"key":"2022032913494980300_ref3","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1007\/s11695-020-04423-5","article-title":"Anastomotic gastro-jejunal ulcer perforation following one anastomosis gastric bypass: clinical presentation and options of management-case series and review of literature","volume":"30","author":"Abou Hussein","year":"2020","journal-title":"Obes Surg"},{"key":"2022032913494980300_ref4","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s11695-013-1118-5","article-title":"Development of ulcer disease after Roux-en-Y gastric bypass, incidence, risk factors, and patient presentation: a systematic review","volume":"24","author":"Coblijn","year":"2014","journal-title":"Obes Surg"},{"key":"2022032913494980300_ref5","article-title":"Marginal ulcers are less responsive to proton pump inhibitors compared to gastric ulcers: a case-control study","volume":"7","author":"Geng","year":"2020","journal-title":"Austin J Gastroenterol"},{"key":"2022032913494980300_ref6","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s11605-018-4047-8","article-title":"Laparoscopic repair for perforated peptic ulcer disease has better outcomes than open repair","volume":"23","author":"Quah","year":"2019","journal-title":"J Gastrointest Surg"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2022\/3\/rjac112\/43056674\/rjac112.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2022\/3\/rjac112\/43056674\/rjac112.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T13:51:36Z","timestamp":1648561896000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjac112\/6554511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjac112","relation":{},"ISSN":["2042-8812"],"issn-type":[{"type":"electronic","value":"2042-8812"}],"subject":[],"published-other":{"date-parts":[[2022,3]]},"published":{"date-parts":[[2022,3,1]]},"article-number":"rjac112"}}