All surgeries have a risk of complications, and weight loss surgery is no exception. As many as one in ten weight loss surgery patients experience a minor or major complication, so it is important to know what symptoms indicate a normal recovery from surgery and which ones should be more alarming. For example, after surgery some pain is expected and should be considered perfectly normal; however, sudden, excruciating pain that cannot be controlled would not be considered normal.

Emergencies are rare after weight loss surgery; only 2–3 percent of patients ever experience a life-threatening complication, but early identification of a problem is essential. If you believe you are having a complication that is a potential emergency, do not hesitate to contact your surgeon. You may be tempted to wait until the next morning if it is late at night, but it is not advisable to do so.

If you do decide to go to the emergency room, you will need to explain very clearly that you have had a recent weight loss procedure. For example, “I had Roux-En-Y gastric bypass surgery two weeks ago, performed by Dr. Smith. I was discharged from Jones Hospital ten days ago. I am here because I was told that if I noticed any shortness of breath I should report to the emergency room and have the staff contact the doctor immediately.” Knowing your recent surgical history will be helpful to the staff as they work to determine the nature of your problem.

Bleeding after Surgery

For gastric bypass procedures a small amount of blood in the stool in the first few days after surgery is not unheard of, but you should make your surgeon aware of it, as it is not typical. Any other bleeding, such as vomiting blood or bleeding from incisions, should be reported to the surgeon immediately. Stool that is dark in color and tarry in appearance also indicates the presence of blood and should be reported.

Difficulty Breathing

Shortness of breath or difficulty breathing should never be ignored. Unexplained shortness of breath can indicate a major complication, such as a blood clot in the lungs, so reporting this symptom to your surgeon is absolutely essential. If the difficulty is severe, consider calling 911 and seeking treatment from emergency medical technicians (EMTs), rather than waiting to hear from your surgeon.

Blood Clots Deep vein thrombosis (DVT) is the name given to blood clots that occur after surgery. Blood clots typically form in the legs, but they can form in other locations, or they can move through the bloodstream to form a clot elsewhere. Leg pain, along with redness and warmth over the site of pain, cramping, and numbness can indicate that a blood clot has occurred. In some cases, the affected leg may be larger than the other, as blood begins to “back up” in the limb.

Patients who have experienced blood clots in the past are at greater risk for a clot than patients who have never had one. Clots are considered a medical emergency because they can cause tissue damage in the affected limb, but they can also travel to the vessels of the lungs, causing a pulmonary embolus, or to the brain, causing a stroke.

Suture Line Disruption (SLD)

Suture line disruption is the medical term for a line of sutures or staples that is no longer intact, with one or more of the stitches or staples coming loose. It can occur in bypass procedures such Roux-En-Y, where the anatomy of the body has been changed, and in procedures that alter the size of the stomach. It does not occur in gastric banding patients.

SLD can allow food and fluids to move out of the GI tract, possibly causing a life-threatening infection to develop. This complication typically presents as a significant increase in pain and may be accompanied by a fever if an infection has started. Blood may also be present in the stool.