Prior Roux-en-Y Gastric Bypass Patient With Duodenal Fistula After Perforated Duodenal Ulcer Case Report.

Perforated duodenal ulcers are a rare occurrence in patients with a history of Roux-en-Y gastric bypass (RNYGB). This case report is of a patient who had two separate presentations of perforated duodenal ulcer despite a history of RNYGB and who progressed to a high-output duodenal-cutaneous fistula after failing the second Graham patch. This highlights the impact ulcer disease can have even in RNYGB patients.