AI Article Synopsis
- An obese patient experienced ITSM after LSG due to an incomplete hiatal repair, leading to vomiting and requiring laparoscopic exploration and reoperation.
- The reoperation revealed the upper sleeve was entrapped but didn't cause gastric ischemia; the symptoms improved post-surgery, and the patient achieved weight loss without reflux complaints.
Article Abstract
Concomitant hiatal hernia repair during laparoscopic sleeve gastrectomy (LSG) is recommended if it is detected. Intrathoracic sleeve migration (ITSM) is a sliding hiatal hernia that develops after LSG. In this article, we present an early ITSM due to an incomplete repair of a hiatal hernia. An obese patient had hiatal hernia in the preoperative endoscopy. After LSG, the defect was repaired with anterior cruroplasty. Vomiting attacks were observed after the operation. Based on clinical signs and radiological findings, laparoscopic exploration was indicated. During the reoperation, an acute entrapment of the upper portion of the sleeve was observed, which had migrated through the hiatus. This suture was undone. There was no gastric ischemia. No additional hiatal repair was attempted. The operation was sufficient to alleviate the symptoms. The patient was discharged on the second postoperative day uneventfully. Until the most recent follow-up, the patient has progressed with adequate weight loss, without complaints of reflux and without proton pump inhibitors ITSM with incarceration is a complication that can occur after incomplete hiatal repair. Failure to perform hiatal repair with proper technique can be attributed to this complication.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744407 | PMC |
| http://dx.doi.org/10.7759/cureus.31362 | DOI Listing |
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