Fulminant Necrotizing Enteritis after Revisional Roux-en-Y Gastric Bypass: A Rare Case and Review of the Literature

Background: We report the first case of Pseudomonas necrotizing enteritis in an adult patient after undergoing revision Roux-en-Y gastric bypass. This rare condition has been reported only in the healthy pediatric population. The diagnosis and management of our case was challenging, which is in agreement with the available pediatric literature we summarize in our report. Conclusion: Despite timely medical and surgical intervention (when indicated), Pseudomonas necrotizing enteritis has a reported high mortality reaching 89%. Pseudomonas aeruginosa is an important opportunistic pathogen frequently affecting patients with chronic diseases and compromised immune status that can result in high mortality [1]. Patients with prolonged antibiotic exposure can also develop uncomplicated intestinal colonization secondary to Pseudomonas aeruginosa that presents as diarrhea [2]. Sepsis from Pseudomonas enteritis, termed Shanghai fever, is rare, and has been reported only in healthy pediatric patients in Asian countries [3,4]. We report the first case of necrotizing Pseudomonas enteritis in an adult after revisional robot-assisted Roux-en-Y gastric bypass (RYGB).