[Abdominal pain in a pregnant patient who had gastric reduction surgery: risks associated with a history of bariatric surgery]

Pregnant women who previously had bariatric surgery may develop acute abdominal pain during pregnancy that may be related to previous operations. Two patients, a 38-year-old twin-primigravida who had a gestation period of 24+6 weeks and a 26-year-old woman who had a gestation period of 24 weeks, both of whom had laparoscopic gastric bypass (RYGB) surgery 2 and 3 years previously, developed abdominal pain. The patients were not ill, but had diffuse abdominal pain in combination with normal blood tests and imaging. Patient B had undergone laparoscopy at another centre after 5 weeks of gestation for internal herniation. After referral to our multidisciplinary Bariatric-Obstetric-Neonatal (MD-BON) team, diagnostic laparoscopy was advised as internal herniation was deemed possible. In both patients, internal herniation was indeed found in Petersen's space and jejunal mesenteric defect, which was closed using laparoscopic surgery. Both women delivered healthy offspring afterwards. The presence of a MD-BON team allows for an increased awareness of potential long-term complications associated with earlier bariatric surgery in pregnancy.