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From the Division of Gastrointestinal and Minimally Invasive Surgery in the Department of Surgery at the Carolinas Medical Center in Charlotte, NC.

Address correspondence to Ronald F. Sing, DO, Department of General Surgery, Carolinas Medical Center, 1000 Blythe Blvd, MEB 601, Charlotte, NC 28203-5812. E-mail: rsing{at}carolinas.org

Postoperative upper gastrointestinal bleeding, though rare, is a potentially fatal complication of gastric bypass surgery that usually occurs a few months postoperation. The current report describes a 57-year-old man with a bleeding duodenal ulcer who underwent Roux-en-Y gastric bypass surgery 12 years earlier. With an increasing number of gastric bypass surgeries performed each year, physicians must be aware of their patients' altered gastrointestinal anatomy and physiology—as well as the potential for pathophysiology.