With the rising prevalence of obesity and the increasing utilization of bariatric surgery, general surgeons are increasingly encountering patients presenting with acute postoperative complications. While bariatric procedures are generally safe and effective, they carry a unique profile of surgical and metabolic emergencies due to altered anatomy, nutritional vulnerability, and technical complexity. Given that many patients present to non-bariatric centers, it is essential for general surgeons to be equipped to recognize and manage these emergencies. This narrative review aims to provide a comprehensive, procedure-specific guide for general surgeons on the diagnosis and management of bariatric surgical emergencies. It emphasizes timely recognition, key diagnostic principles, and tailored operative and nonoperative strategies, while also highlighting system-level challenges and disparities affecting outcomes. We reviewed the clinical presentation, pathophysiology, and evidence-based management of major categories of bariatric emergencies, including anastomotic leaks, internal hernias, bowel obstruction, bleeding, marginal ulcers, band-related complications, thrombotic events, and nutritional crises. We also examined the distinct challenges posed by revisional surgery. Consideration was given to disparities in access to care, delayed diagnosis, and the role of structured referral systems and enhanced recovery pathways. General surgeons play a critical frontline role in the management of bariatric emergencies. Familiarity with altered anatomy, procedure-specific risks, and atypical presentations is essential. Early imaging, prompt intervention, and multidisciplinary collaboration can significantly improve outcomes. In parallel, addressing systemic barriers and improving access to specialized care are necessary to ensure equitable and high-quality care for the growing population of bariatric surgery patients.
Abstract
Journal Article
Review
eng
42160232
Tan, Dean K., et al. "Managing Bariatric Surgical Emergencies: Evidence-Based Approaches for General Surgical Practice." The American Surgeon, 2026, p. 31348261451727.
Tan DK, Jawed AE, Merchant AM. Managing Bariatric Surgical Emergencies: Evidence-Based Approaches for General Surgical Practice. Am Surg. 2026.
Tan, D. K., Jawed, A. E., & Merchant, A. M. (2026). Managing Bariatric Surgical Emergencies: Evidence-Based Approaches for General Surgical Practice. The American Surgeon, 31348261451727. https://doi.org/10.1177/00031348261451727
Tan DK, Jawed AE, Merchant AM. Managing Bariatric Surgical Emergencies: Evidence-Based Approaches for General Surgical Practice. Am Surg. 2026 May 20;31348261451727. PubMed PMID: 42160232.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Managing Bariatric Surgical Emergencies: Evidence-Based Approaches for General Surgical Practice.
AU - Tan,Dean K,
AU - Jawed,Aram E,
AU - Merchant,Aziz M,
Y1 - 2026/05/20/
PY - 2026/5/20/medline
PY - 2026/5/20/pubmed
PY - 2026/5/20/entrez
KW - bariatrics
KW - general surgery
KW - surgical complications
SP - 31348261451727
EP - 31348261451727
JF - The American surgeon
JO - Am Surg
N2 - With the rising prevalence of obesity and the increasing utilization of bariatric surgery, general surgeons are increasingly encountering patients presenting with acute postoperative complications. While bariatric procedures are generally safe and effective, they carry a unique profile of surgical and metabolic emergencies due to altered anatomy, nutritional vulnerability, and technical complexity. Given that many patients present to non-bariatric centers, it is essential for general surgeons to be equipped to recognize and manage these emergencies. This narrative review aims to provide a comprehensive, procedure-specific guide for general surgeons on the diagnosis and management of bariatric surgical emergencies. It emphasizes timely recognition, key diagnostic principles, and tailored operative and nonoperative strategies, while also highlighting system-level challenges and disparities affecting outcomes. We reviewed the clinical presentation, pathophysiology, and evidence-based management of major categories of bariatric emergencies, including anastomotic leaks, internal hernias, bowel obstruction, bleeding, marginal ulcers, band-related complications, thrombotic events, and nutritional crises. We also examined the distinct challenges posed by revisional surgery. Consideration was given to disparities in access to care, delayed diagnosis, and the role of structured referral systems and enhanced recovery pathways. General surgeons play a critical frontline role in the management of bariatric emergencies. Familiarity with altered anatomy, procedure-specific risks, and atypical presentations is essential. Early imaging, prompt intervention, and multidisciplinary collaboration can significantly improve outcomes. In parallel, addressing systemic barriers and improving access to specialized care are necessary to ensure equitable and high-quality care for the growing population of bariatric surgery patients.
SN - 1555-9823
UR - https://www.unboundmedicine.com/prime/citation/42160232/Managing_Bariatric_Surgical_Emergencies:_Evidence-Based_Approaches_for_General_Surgical_Practice.
DB - PRIME
DP - Unbound Medicine
ER -
