{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T09:45:22Z","timestamp":1781343922700,"version":"3.54.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T00:00:00Z","timestamp":1581379200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Roux-en-Y gastric bypass (RYGB) is one of the most frequently performed bariatric procedures worldwide. The postoperative incidence of cholelithiasis after RYGB is higher than in the general population (30% vs. 2\u20135%), because the altered anatomy may lead to impaired gallbladder motility and biliary stasis. We report the case of a 47-year-old female who presented 9\u00a0years after RYGB and cholecystectomy with acute pain in the upper abdomen because of a retroperitoneal perforation of a duodenal diverticulum. Intraoperatively, a huge enterolith was found in the diverticulum and removed via duodenotomy. We claim that the stone grew during the sober states as the bile accumulated locally, because the gall bladder has already been removed and no duodenal food passage remained. This acute and life-threatening situation was successfully managed by operation. Consequently, a duodenal diverticulum has to be considered as a possible but very rare complication after RYGB and cholecystectomy.<\/jats:p>","DOI":"10.1093\/jscr\/rjz383","type":"journal-article","created":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T20:10:31Z","timestamp":1576008631000},"source":"Crossref","is-referenced-by-count":6,"title":["Retroperitoneal perforation of a duodenal diverticulum containing a large enterolith after Roux-en-Y bypass and cholecystectomy"],"prefix":"10.1093","volume":"2020","author":[{"given":"Nina","family":"Kabelitz","sequence":"first","affiliation":[{"name":"Department of Visceral Surgery, Kantonsspital Graub\u00fcnden, Chur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Brinken","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, Kantonsspital Graub\u00fcnden, Chur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf","family":"Bumm","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, Kantonsspital Graub\u00fcnden, Chur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,2,10]]},"reference":[{"key":"2020021021232425500_ref1","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1016\/j.soard.2017.07.022","article-title":"Surgical management of enterolith ileus after roux-en-Y gastric bypass","volume":"13","author":"Ortega","year":"2017","journal-title":"Surg Obes Relat Dis"},{"key":"2020021021232425500_ref2","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1007\/s00464-013-3361-1","article-title":"Causes of small bowel obstruction after roux-en-Y gastric bypass: a review of 2,395 cases at a single institution","volume":"28","author":"Elms","year":"2014","journal-title":"Surg Endosc"},{"key":"2020021021232425500_ref3","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.suc.2014.01.003","article-title":"Biliary issues in the bariatric population","volume":"94","author":"Grover","year":"2014","journal-title":"Surg Clin North Am"},{"key":"2020021021232425500_ref4","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1177\/000313481708301215","article-title":"Laparoscopic exploration can salvage recurrent common bile duct stone after cholecystectomy","volume":"83","author":"Liu","year":"2017","journal-title":"Am Surg"},{"key":"2020021021232425500_ref5","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1080\/00365521.2018.1438507","article-title":"Evaluation of risk factors for recurrent primary common bile duct stone in patients with cholecystectomy","volume":"53","author":"Yoo","year":"2018","journal-title":"Scand J Gastroenterol"},{"key":"2020021021232425500_ref6","doi-asserted-by":"crossref","first-page":"82114","DOI":"10.18632\/oncotarget.18839","article-title":"Endoscopic retrograde cholangiopancreatography versus laparoscopic exploration for common bile duct stones in post-cholecystectomy patients: a retrospective study","volume":"8","author":"Wang","year":"2017","journal-title":"Oncotarget"},{"key":"2020021021232425500_ref7","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/j.amjsurg.2015.07.003","article-title":"Management of biliary symptoms after bariatric surgery","volume":"210","author":"Brockmeyer","year":"2015","journal-title":"Am J Surg"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2020\/2\/rjz383\/32394337\/rjz383.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jscr\/article-pdf\/2020\/2\/rjz383\/32394337\/rjz383.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T12:11:54Z","timestamp":1613045514000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjz383\/5729293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,1]]},"references-count":7,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjz383","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,2]]},"published":{"date-parts":[[2020,2,1]]},"article-number":"rjz383"}}