SAQ 293 – General Surgery – abdominal pain after gastric bypass with metabolic alkalosis

A 37-year-old woman presents with worsening abdominal pain. Four months ago she had gastric bypass surgery for morbid obesity and has lost 40 kg. Her venous blood gas is shown below.

Test	Result	Reference range
pH	7.48	7.35-7.45
pCO2	45 mmHg	35-45
pO2	69 mmHg	60-85
HCO3	33 mmol/L	22-28
Na	126 mmol/L	135-145
K	1.8 mmol/L	3.5-4.5
Cl	84 mmol/L	95-110
Glucose	5.9 mmol/L	3.0-7.8

State your interpretation of the VBG.

(Marked out of 2.0)

/ 2

List two (2) potential causes of these VBG results.

(Marked out of 2.0)

/ 2

For an abdominal CT with IV contrast, the radiologist recommends a small amount of water 15 minutes before scanning. State two (2) reasons for this.

(Marked out of 2.0)

/ 2

The CT is reported as normal, but her pain and clinical condition worsen despite multimodal analgesia. State your next management step and rationale.

(Marked out of 2.0)

Management	Rationale

/ 2

List four (4) late complications of gastric bypass bariatric surgery.

(Marked out of 4.0)

/ 4

Total Score: 0 / 12

Percentage: 0%