• Strictures and bowel obstruction

Severe formation of scar tissues and the kinking at specific sites of the intestine can lead to narrowing or blockage of the intestine.  This can manifest as inability to hold down foods and fluids.  Signs and symptoms include:  vomiting, abdominal distension and pain.   Complications related to bowel obstructions and strictures need to be corrected as soon as possible to avoid any further complications.

•  Bleeding

Bleeding is a common complication with many types of surgery.  This may occur immediately post-operative to several days after the bariatric surgery.  Depending on the severity of the bleeding, the signs and symptoms manifest differently.  Also, the bleeding may not even be noticeable to the untrained eye.  Monitoring of vital signs in the field during a Non-Emergency Transport and having on site clinicians perform a post-op hemoglobin level check can often help early detection of any major hemmoraghes at which point surgeons can seal off any oozing area and avoid major complications.

•  Leakage through anastomosis

Bariatric surgery basically links up parts of the stomach with portions of the intestine and this invovles anastomosis. Stapling devices are used the majority of the time and in some cases these linked connections can give way. Whenever a leakage of this type occurs there is the risk of intestinal content spilling into the abdominal cavity.  This spillage can lead to serious and in some cases fatal infections like peritonitis and sepsis. Patients should always have a full assessment performed both pre and post-op. Signs and sypmptoms to be on the lookout  for include: elevated temperature, shortness of breath, abdominal pain greater than 6 on the pain scale, abdominal distension and pulsating masses. Often times a careful palpation of all four abdominal quadrants can help detect leakage and internal bleeding early.

•  Pulmonary embolism

 In some cases, patients have developed blood clots in the lower limbs.  This is largely dependent on patient susceptibility to clots and their individual medical history.  The biggest danger with clots is their ability to dislodge and travel towards the lungs. When clots travel to the lungs, this can lead to respiratory distress and failure. This condition can be fatal without early prevention, diagnosis and mobilization.  Also the clinical use of blood thinning agents in susceptible patients has been shown to be of great aid.

•  Nutritional deficiencies

In some cases, gastric bypass surgery may lead to deprivation of certain nutrients.  In this case the clinician can work closely together with a properly certified dietician to prescribe special supplements.
Above and beyond any previously discussed risks and complications, some patients are also susceptible to increased incidence of gallstones, ulcers and other infections. Of course close follow-up can help in avoiding these manifestations.