Introducción: la causa más común de obstrucción intestinal posterior a bypass gástrico en Y de Roux es la herniación interna y se puede resolver mediante abordaje laparoscópico. El objetivo de este trabajo es presentar tres causas inusuales de obstrucción intestinal en pacientes bariátricos que se pueden resolver mediante abordaje de mínima invasión. Reporte de casos: el primer caso presenta una paciente de 31 años con antecedente de bypass gástrico en Y de Roux tres años antes que se presentó con síndrome oclusivo. Se diagnosticó intususcepción que se manejó exitosamente con laparoscopía. El segundo caso es una paciente de 37 años a quien se colocó balón gástrico un año previo a la admisión, quien no se presentó a retiro del balón a los seis meses, acude a hospital con cuadro oclusivo, diagnosticándose impactación distal del balón el cual se extrajo con éxito vía laparoscópica. Último caso, se trata de una paciente de 39 años con historia de bypass gástrico en Y de Roux nueve años previos al ingreso con síndrome oclusivo. En la laparoscopía se encontró fitobezoar de 8 cm impactado en el íleon terminal. Se extrajo manualmente utilizando un separador desechable de 5 cm a través del ombligo. Resultados: dos casos se resolvieron por vía laparoscópica y el tercero se extrajo de manera extracorpórea, pero con abordaje lapa- ABSTRACT Introduction: the most common cause of intestinal obstruction after Roux-en-Y gastric bypass (RYGB) is internal herniation and can be resolved by laparoscopic approach. The objective of this paper is to present three unusual causes of intestinal obstruction in bariatric patients that can be resolved by a minimally invasive approach.Report of cases: The first case presents a 31-year-old patient with a history of Roux-en-Y gastric bypass 3 years previously who presented with an occlusive syndrome. An intussusception was diagnosed and successfully managed with laparoscopy. The second case is a 37-yearold patient who had a gastric balloon placed 1 year prior to admission, who did not attend withdrawal at 6 months, goes to the hospital with an occlusive picture, diagnosing distal impaction of the balloon, which was successfully extracted laparoscopic route. Last case, a 39-yearold patient with a history of Roux-en-Y gastric bypass 9 years prior to admission with occlusive syndrome. Laparoscopy revealed an 8 cm impacted phytobezoar in the terminal ileum. It was manually removed using a 5 cm disposable retractor through the umbilicus. Results: two cases were successfully resolved laparoscopically and the third was extracted extracorporeally, but with a laparoscopic approach. No patient
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