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Candy cane syndrome presenting with refractory heartburn 15 years after Roux-en-Y bypass
Journal article   Open access   Peer reviewed

Candy cane syndrome presenting with refractory heartburn 15 years after Roux-en-Y bypass

Shahana Prakash, Ramses Saavedra, Ryan Lehmann and Mohamad Mokadem
Journal of surgical case reports, Vol.2023(3), rjad130
03/18/2023
DOI: 10.1093/jscr/rjad130
PMCID: PMC10024617
PMID: 36942285
url
https://doi.org/10.1093/jscr/rjad130View
Published (Version of record) Open Access

Abstract

Candy cane syndrome (CCS) is a rare complication of Roux-en-Y gastric bypass (RYGB), in which the afferent jejunal limb is excessively long. Common symptoms include abdominal pain, nausea and vomiting. A 57-year-old female with a history of RYGB 15 years prior to presentation reported 7 months of persistent heartburn refractory to proton pump inhibitors. Upper endoscopy revealed a 9 cm blind, afferent jejunal limb. After the blind limb was resected laparoscopically, her symptoms resolved. Fifteen years is the longest duration reported from time of RYGB to symptom onset of CCS. Furthermore, heartburn is less frequently seen as a presenting complaint of CCS. Clinicians should thus maintain a high index of suspicion for CCS in patients with refractory heartburn and a history of RYGB, regardless of how long ago the RYGB was performed.
010 AcademicSubjects Case Report jscrep MED00910

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