Background

EDS is an inhereted connective tissue disease. Several subtypes have chronic intestinal manifestations and have been shown to have anastomotic leaks after intestinal surgery. There are limited case reports of EDS and BS.

Methods

All BS patients with EDS from 2001-present were reviewed for immediate and long-term complications(IC/LTC), weight loss(WL) and need for revision.

Results

Four patients have had WLS and 3 more are pre-op All were female. Only 1 patient had her diagnosis at the time of her primary BS. She started with a Lap-Band, revised to a Lap Sleeve and ultimately a Gastric Bypass. IC include severe N/V requiring PPN for several weeks. The others were diagnosed at 2,7,14 yrs. after primary WLS. Two had gastric bypass, neither had IC. All 3 have had LT constipation and 2/3 have GERD and dysphagia despite normal pH/M. The final patient had a Lap sleeve, converted to a Lap SAIDI converted to a Roux for bile reflux. The Roux conversion was the one IC- a significant leak that resulted in a 30X110cm abscess (pic). The total body weight loss has been 35-44% (mean-39.5%).

Conclusions

EDS always raises concers of anstomotic issues but sleeve and anastomotic WLS can be done safely. You need to be prepared for post op GI motility issues . However, if there is a leak the soft tissue issues can be profound. Even with a GBP they may have ongoing GERD/dysphagia. Because of delays in diagnosis you may have already operated on someone with EDS.