Background

This video case series presents 3 patients with a remote history of roux-en-y gastric bypass (RYGB) who presented with symptoms and radiographic findings of small bowel obstruction. Patients were taken to the operating room for exploration to rule out adhesive disease or internal hernia however found isolated within the small bowel impaction of food causing obstruction. Each case involves high fiber content foods which impedes adequate digestion secondary to RYGB changes of hypoacidity, loss of pylorus function, inadequate enzymatic degradation. Offending foods ranged from a noodle-based soup, shirataki noodles, and inadequate mastication of dried fruit. Rare cases of small bowel obstructions occur after RYGB from food bezoars. Management may consist of early exploration and conversion to open if required.