Lisa Marie Presley.Photo: Joe Scarnici/Getty
PEOPLE spoke toDr. Terry Dubrow, board-certified plastic and reconstructive surgeon and star ofBotched, about the procedure and some of the complications that may arise.
“The thing about bariatric surgery is there’s a few different kinds,” he tells PEOPLE. “They vary from completely disconnecting parts of the intestines, so you don’t absorb very much, or it involves reducing the size of the stomach, which limits the amount of food you eat.”
Lisa Marie Presley.Todd Williamson/NBC/NBC via Getty
As with any major procedure, bariatric surgery poses potential health risks that can lead to short-term, long-term and fatal complications.
Dubrow — who is also board certified in general surgery — said the most common complications from bariatric surgery are those called malabsorption syndromes, where the patients are not absorbing the usual amounts of vitamins that would be absorbed through a regular diet.
“You’re not absorbing enough vitamin b12 so you’re getting anemic, you’re not absorbing enough nutrients so you can get skin conditions. It’s mainly mechanical,” he adds, noting the importance of patients getting their blood levels tested before and after surgery.
Additionally, another complication of bariatric surgery is a small bowel obstruction, which is what led to Presley’s death.
“The problem is when you go inside the abdomen and you either disconnect part of the intestines to limit absorption or you operate on the stomach itself to limit the volume that you can eat, you induce scarring in and around the area of the intestines. And those are called adhesions,” he explains.
“The most common complication of that kind of surgery is when that scarring is in there, it sometimes can catch pieces of the bowel, or it can impair intestinal motility — the movement of food — and that causes what’s called a small bowel obstruction,” Dubrow continues. “That happens in about 6% of all bariatric type surgery.”
Dr. Terry Dubrow.Trae Patton/E! Entertainment
Trae Patton/E! Entertainment
Symptoms of a small bowel obstruction start with “uncomfortable kind of bloating,” according to Dubrow. That then leads to painful nausea and vomiting. However, many people dealing with this kind of blockage don’t realize the cause because symptoms can often seem like the flu or a stomach ache.
“And this is not something that necessarily happens immediately after the surgery,” Dubrow adds. “This can happen two years, five years, 10 years later. You’re basically always at a risk for intermittent small bowel obstruction.”
Many times a small bowel obstruction can resolve on its own. However, if it continues to the point where it doesn’t allow the food to progress through the body, swelling can occur, which can cut off blood supply.
“Once the blood supply to the intestines gets cut off, that can result in small bowel necrosis, meaning your intestines die,” Dubrow says. “So you can be walking around with a tummy ache, you can have a small bowel obstruction and unbeknownst to you, inside of the abdomen, your intestines are dying. Once your intestines die enough, that is life-threatening.”
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Two surgeons preparing for surgery.XiXinXing/Getty Images
Additionally, the toxicology results in Presley’s autopsy also concluded that levels of oxycodone remained in her blood at the time of death. Months prior, she had another cosmetic surgery and was prescribed medicine for the pain.
Dubrow — who stresses that he was not Presley’s doctor — believes that the combination of bariatric surgery and pain medication could have been the “perfect storm” of predisposing factors to the small bowel obstruction.
“Oftentimes when you have plastic surgery, you often take pain pills, you take opioids. They found oxycodone in Lisa Marie, which is very common to take after plastic surgery,” he explains. “But when you take opioids, that also slows down the intestinal tract.”
Dubrow urges patients who have had bariatric surgery to be more concerned with any symptoms that arise and seek medical attention.
“Don’t just assume it’s a tummy ache. Don’t just assume you have the flu. If you have nausea, vomiting, bloating, abdominal pain, be a lot more concerned that you may be developing or have developed a small bowel obstruction,” he says.
“You need to have a higher index of suspicion that this could be a problem,” Dubrow tells PEOPLE. “Don’t let it go all day, all night into the next day. You want to go to your urgent care and get a very simple x-ray of your abdomen that can instantly determine whether you have a small bowel obstruction.”
source: people.com
