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Life sciences · Journal article
International Journal of Surgery Case Reports · August 12, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a case report of a 67-year-old woman who developed catastrophic, refractory malnutrition years after Roux-en-Y gastric bypass, triggered by a cascade of osteoporosis-related fracture, immobilization, stress-induced marginal ulceration with perforation, and prolonged fasting. The case illustrates vulnerability to delayed synergistic complications in long-term RYGB survivors and highlights the need for lifelong nutritional surveillance and early multidisciplinary intervention, but provides no quantitative data on incidence, risk factors, or treatment efficacy to guide practice.
Case report. A 67-year-old woman with prior Roux-en-Y gastric bypass for severe obesity presenting with late-onset multifactorial malnutrition.. Intervention: Intensive nutritional rehabilitation including combined enteral feeding via oral route and feeding gastrostomy, alongside parenteral nutritional support..
67-year-old woman with prior RYGB developed osteoporosis-related fragility fracture leading to immobilization Subsequent stress- and medication-induced marginal ulceration complicated by perforation and prolonged fasting Resulted in profound macro- and micronutrient deficiencies refractory to conventional oral and parenteral supplementation
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians caring for long-term RYGB survivors should maintain heightened vigilance for delayed complications, especially during hospitalizations for seemingly unrelated conditions, and involve bariatric specialists early to prevent irreversible malnutrition. The case underscores that anatomical and absorptive changes persist indefinitely and may interact synergistically with other medical events.
A single case report describing a rare complication cascade; raises important clinical awareness but lacks comparator data, control group, or generalizable quantitative evidence.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians caring for long-term RYGB survivors should maintain heightened vigilance for delayed complications, especially during hospitalizations for seemingly unrelated conditions, and involve bariatric specialists early to prevent irreversible malnutrition. The case underscores that anatomical and absorptive changes persist indefinitely and may interact synergistically with other medical events.
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Introduction and importance: Roux-en-Y gastric bypass (RYGB) is an effective metabolic procedure with durable weight loss and metabolic benefits. However, catastrophic late-onset malnutrition is rarely reported, particularly when multiple long-term complications interact sequentially. We present a case illustrating a multihit cascade of skeletal and gastrointestinal events culminating in life-threatening refractory malnutrition long after RYGB. Presentation of case: A 67-year-old woman with a history of RYGB for severe obesity developed an osteoporosis-related fragility fracture, followed by prolonged immobilization. During subsequent hospitalization, she experienced stress- and medication-induced marginal ulceration, complicated by perforation and prolonged fasting. These events collectively precipitated profound macro- and micronutrient deficiencies that were refractory to conventional oral and parenteral supplementation. The patient was managed with intensive nutritional rehabilitation, including combined enteral feeding via the oral route and a feeding gastrostomy, alongside parenteral nutritional support. Recovery was markedly protracted, underscoring the severity and refractoriness of the nutritional derangement. Clinical discussion: This case demonstrates that patients who have undergone RYGB remain vulnerable to delayed, synergistic complications arising from altered gastrointestinal anatomy, impaired absorptive capacity, chronic acid suppression, and age-related physiological decline, which can culminate in catastrophic malnutrition years to decades after surgery. Conclusion: Increased awareness among general clinicians, particularly during hospitalizations for unrelated medical conditions, together with lifelong nutritional surveillance, early multidisciplinary involvement, and timely referral to bariatric specialists is essential to prevent irreversible nutritional deterioration in long-term survivors of bariatric surgery.
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