Prior Roux‐en‐Y Gastric Bypass Patient With Duodenal Fistula After Perforated Duodenal Ulcer Case Report

Perforated duodenal ulcers are a rare occurrence in patients with a history of Roux‐en‐Y gastric bypass (RNYGB). This case report is of a patient who had two separate presentations of perforated duodenal ulcer despite a history of RNYGB and who progressed to a high‐output duodenal‐cutaneous fistula after failing the second Graham patch. This highlights the impact ulcer disease can have even in RNYGB patients.