SVOA Medical Research

M. Cao MD¹, Kristen Bridges MD¹, Pratibha Vemulapalli MD¹, Jaime Sexton MSc¹ and Brian Gilchrist MD^1*

¹ The Brooklyn Hospital Center, New York, USA.

*Corresponding Author: Brian Gilchrist MD , The Brooklyn Hospital Center, New York, USA.

DOI: https://doi.org/10.58624/SVOAMR.2023.01.004

Received: June 21, 2023     Published: August 03, 2023

Abstract

Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the United States and is widely accepted due to its technical ease and effectiveness. Concomitant hiatal hernia repair, if detected during an LSG, is recommended. Intrathoracic sleeve migration (ITSM), a sliding hiatal hernia that develops after LSG, is a rare complication of this procedure. This report presents an early case of ITSM due to intermittent retching, resulting in postoperative incarceration of the proximal sleeve. The patient is a 28-year-old female who underwent concomitant LSG and hiatal hernia repair and was readmitted for acute entrapment of the proximal portion of the sleeve. The patient underwent re-operation with reduction of the proximal sleeve, and omentopexy was performed for stabilization. Intraoperative esophagogastroduodenoscopy was performed to ensure the detorsion and patency of the sleeve before the surgery. No additional hiatal hernia repair was attempted. ITSM with incarceration is an interesting phenomenon that is underrecognized and underreported. It can present postoperatively with reflux symptoms and poor oral tolerance. Failure to make an accurate diagnosis and intervene can result in prolonged hospitalization and poor patient outcomes.

Keywords: postoperative sleeve gastrectomy complications, hiatal hernia repair, bariatric surgery, bowel volvulus, sleeve gastrectomy.

Citation: M. Cao, Bridges K, Vemulapalli P, Sexton J, Gilchrist B. Case Report: Acute Intrathoracic Sleeve Migration with Partial Volvulus after Laparoscopic Sleeve Gastrectomy and Hiatal Hernia Repair. SVOA Medical Research 2023, 1:1, 17-19.