Challenge scenario: mid-gastric stenosis and gastric tube twist following laparoscopic sleeve gastrectomy.
Ting-Yi ChuWan-Ting HungGuo-Shiou LiaoKuo-Feng HsuPublished in: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva (2022)
The incidence of gastric stenosis, a complication of laparoscopic sleeve gastrectomy (LSG), has been reported to range from 0.7% to 4%. Only 1.1% of stenosis develop symptoms that require endoscopic or surgical intervention. We herein report a challenging case of mid-gastric stenosis and gastric tube twist following LSG. A 38-year-old woman with an initial body mass index (BMI) of 35 kg/m2 and metabolic syndrome undergoing LSG. A week after surgery, the patients developed intermittent vomiting and eating difficulty. Gastroscopy and following diagnostic laparoscopy were performed 3 weeks after LSG, subsequently revealing unusual mid-gastric stenosis and gastric tube twist. Initial conservative treatment and endoscopic balloon dilatation were implemented but failed. The patient received laparoscopic revisional Roux-en-Y gastric bypass and recovered well. A follow-up after 2 years revealed that her BMI decreased to 22.1 kg/m2. In conclusion, post-LSG stenosis is a serious complication that requires early detection and prompt management. Prompt revisional surgery is necessary for complicated stenosis.
Keyphrases
- physical activity
- body mass index
- roux en y gastric bypass
- metabolic syndrome
- sleep quality
- gastric bypass
- weight loss
- epithelial mesenchymal transition
- randomized controlled trial
- end stage renal disease
- minimally invasive
- chronic kidney disease
- type diabetes
- cardiovascular disease
- ejection fraction
- clinical trial
- obese patients
- case report
- bariatric surgery
- risk factors
- signaling pathway
- atrial fibrillation
- preterm birth
- insulin resistance
- high intensity
- gestational age