Altieri MS, et al. – The objective of this study was to investigate incidence of perforated marginal ulcers (pMU) following Roux–en–Y Gastric Bypass (RYGB) and assess the natural history of this complication. Following RYGB, the incidence of pMU is small. They found that anastomotic revision for pMU is correlated with prolonged length of stay compared to repair alone. Remarkably, recurrence after intervention of pMU is common, demonstrating possible value of a routine surveillance program for patients following pMU.