Lisa Marie Presley’s cause of death was made public earlier this week. According to an autopsy report obtained by PEOPLE, the 54-year-old singer-songwriter passed away in January from a “sequelae of a small bowel obstruction” that manifested after she had bariatric surgery a few years prior.
According to the report, the obstruction was a strangulated small bowel brought on by adhesions that formed following her weight-loss surgery. Deputy Medical Examiner Dr. Juan Carrillo stated, “This is a known long-term complication of this type of surgery.”.
In order to reduce how much food a person can eat and absorb, the digestive system—typically the stomach and small intestine—is surgically altered during bariatric surgery, which is a general term for gastric bypass and other weight loss procedures.
Board-certified plastic and reconstructive surgeon Dr. Terry Dubrow, who also happens to be a star of the TV show Botched, spoke with PEOPLE about the procedure and some potential complications.
There are several different types of bariatric surgery, he tells PEOPLE. “They range from completely cutting off portions of the intestines, which makes it difficult to absorb much, to reducing the size of the stomach, which restricts how much food you can eat. ”.
Dubrow notes that he assumes Presley’s surgeon would have ensured she met those weight requirements.
Patients must have a body mass index (BMI) of greater than 40 in order to undergo bariatric surgery, as required — typically by insurance companies — and have an associated medical condition for which obesity is one of the major risk factors, Dubrow says.
Bariatric surgery carries potential health risks, which can result in short-term, long-term, and fatal complications, just like any major procedure.
The majority of post-bariatric surgery complications, according to Dubrow, who is also board-certified in general surgery, are referred to as malabsorption syndromes, in which patients do not absorb the typical levels of vitamins that they would through a regular diet.
You’re not absorbing enough vitamin B12, which causes you to become anemic, and you’re not absorbing enough nutrients, which causes skin conditions. He continues, “Most of it is mechanical, which is why it’s crucial for patients to have blood tests both before and after surgery.
The obstruction of the small bowel, which caused Presley’s death, is yet another side effect of bariatric surgery.
The issue is that when you operate inside the abdomen to either disconnect a portion of the intestines to limit absorption or to operate on the stomach itself to limit how much you can eat, you cause scarring in and around the area of the intestines. And those are known as adhesions, he adds.
The most frequent issue with this type of surgery is scarring, which can occasionally catch bits of the bowel or impair intestinal motility, which results in what is known as a small bowel obstruction. About 6% of bariatric surgery cases involve that. ”.
According to Dubrow, bloating of an “uncomfortable kind” is the first sign of a small bowel obstruction. This causes unpleasant nausea and vomiting to follow. However, due to symptoms that frequently resemble the flu or a stomachache, many people who experience this kind of blockage are unaware of the cause.
And this doesn’t always happen right away after the operation, says Dubrow. Two, five, or ten years from now, this could still occur. Small bowel obstructions that occur occasionally are essentially always a possibility.
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Small bowel obstructions frequently clear up on their own. Swelling may develop, which may cut off the blood supply, if it persists to the point where it prevents the food from passing through the body.
Small bowel necrosis, or the death of your intestines, can occur once the blood supply to them is severed, according to Dubrow. So, even though you may have a small bowel obstruction and a stomachache, your intestines may be dying inside your abdomen. When your intestines start to perish, you risk dying. ”.
The toxicology findings from Presley’s autopsy also came to the conclusion that oxycodone levels were still present in her blood at the time of death. She had another cosmetic procedure months prior, and pain medication was prescribed.
Dubrow, who emphasizes that he was not Presley’s doctor, thinks that the “perfect storm” of risk factors for the small bowel obstruction may have included both the bariatric procedure and painkillers.
“You take painkillers and opioids frequently after having plastic surgery. Oxycodone, which is frequently taken after cosmetic surgery, was discovered in Lisa Marie, he says. But taking opioids slows down the intestinal tract as well. ” .
This means that taking opioids after recent plastic surgery and having scarring from a previous gastric bypass surgery can predispose you to a small bowel obstruction, he continues.
After undergoing bariatric surgery, patients are urged by Dubrow to pay closer attention to any new symptoms and seek medical attention.
“Don’t just assume it’s a stomachache. Make no assumptions that you have the flu. Be much more concerned that you may be developing or have developed a small bowel obstruction if you experience nausea, vomiting, bloating, or abdominal pain, he advises.
“You need a higher index of suspicion that this could be a problem,” Dubrow tells PEOPLE. “Don’t let it drag into the following day all day and night. You should visit the urgent care facility and get a quick abdominal x-ray, which will reveal whether you have a small bowel obstruction right away. ”.
