Acute Intrathoracic Migration With Incarceration of Laparoscopic Sleeve Gastrectomy Due to Incomplete Hiatal Hernia Repair

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.

Case Report: Acute Intrathoracic Sleeve Migration with Partial Volvulus after Laparoscopic Sleeve Gastrectomy and Hiatal Hernia Repair

“…Surgical intervention is necessary to prevent gastric ischemia and other complications associated with ITSM. [1][2][3][4][5][6][7][8][9][10][11]…”

“…This report presents a case of acute incarcerated hiatal hernia with partial volvulus due to ITSM in a patient who underwent concomitant hiatal hernia repair with LSG. [1][2][3][4][5][6][7][8][9][10][11]…”