A 45-year-old female with history of morbid obesity status post Roux-en-Y gastric bypass (RYGB) six months ago for weight loss presents to the emergency department with acute on chronic abdominal pain. She reports that these upper gastrointestinal (UGI) symptoms have been occurring with increasing frequency over the past two months. Her pain is epigastric, postprandial and without radiation. It is associated with nausea, vomiting and early satiety. She denies fever, and reports that these intermittent obstructive symptoms occur after meals and only resolve after vomiting and regurgitation of the meal.

A 45-year-old female with history of morbid obesity status post Roux-en-Y gastric bypass (RYGB) six months ago for weight loss presents to the emergency department with acute on chronic abdominal pain. She reports that these upper gastrointestinal (UGI) symptoms have been occurring with increasing frequency over the past two months. Her pain is epigastric, postprandial and without radiation. It is associated with nausea, vomiting and early satiety. She denies fever, and reports that these intermittent obstructive symptoms occur after meals and only resolve after vomiting and regurgitation of the meal.