Closed-Loop Gangrene Post Banded Roux-en-Y Gastric Bypass (B-RYGB)

Although laparoscopic banded Roux-en-Y gastric bypass (B-RYGB) has been adopted in bariatric surgery to enhance long-term weight loss outcomes and reduce pouch dilation, cranial slippage (herniation) of the alimentary limb through a non-slipped MiniMizer gastric ring (Bariatric Solutions International GmbH, Stein am Rhein, Switzerland) following B-RYGB, leading to small bowel ischemia, represents a rare but serious complication. We present a case of a 35-year-old male who had undergone multiple bariatric procedures to manage obesity due to failure to lose weight. The patient presented to our emergency department in December 2024 with features of an acute surgical abdomen, eight months after undergoing laparoscopic B-RYGB using a MiniMizer gastric ring. This case report contributes to the growing body of literature on complications associated with B-RYGB, particularly those related to the MiniMizer gastric ring.