sepsis due to breakdown of oesophageal/gastric anastomosis following laparoscopic revision of gastric bypass
AI-generated summary
A 73-year-old woman died from sepsis due to breakdown of oesophageal/gastric anastomosis following laparoscopic revision of gastric bypass surgery. She had complex medical history with multiple post-operative complications including haematemesis, dehydration, vomiting, and deep vein thrombosis. The critical failure was delayed recognition and management of sepsis in the immediate post-operative period (from 25 January 2022 onwards). Despite MET calls being made, an intensivist was not involved early enough. The coroner found the response to post-surgical complications was below acceptable standard. Early recognition of sepsis signs, prompt intensivist involvement, early potent intravenous antibiotics, renal replacement therapy, and circulatory support may have altered the outcome.
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Specialties
bariatric surgerygeneral surgeryintensive careemergency medicine
gastric band removallaparoscopic single anastomosis gastric bypasscolonoscopylaparoscopic reversal of gastric bypassintra-operative gastroscopynaso-enteric tube insertionmanual disimpaction
Contributing factors
failure to identify sepsis with certainty in immediate post-operative period
delayed involvement of intensivist
anastomotic breakdown with perforation
delayed recognition of clinical deterioration
complex post-operative course with multiple complications
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