Acute incarcerated intrathoracic sleeve herniation after laparoscopic sleeve gastrectomy: an uncommon yet urgent complication-a comprehensive case report and literature review

Emerg Radiol. 2023 Dec;30(6):811-816. doi: 10.1007/s10140-023-02182-1. Epub 2023 Nov 7.

Abstract

Laparoscopic sleeve gastrectomy (LSG) stands as one of the most frequently performed bariatric procedures in the USA. While hiatal hernia or intrathoracic migration of the staple line is frequently described as a chronic complication, this review article sheds light on the seldom-discussed acute presentation of this alarming complication. We present a compelling case of a young female who experienced sudden and intractable vomiting shortly after LSG. Utilizing a multidisciplinary approach, upper gastrointestinal imaging (UGI) and computed tomography (CT) scans unequivocally confirmed incarcerated intrathoracic migration of the gastric sleeve, necessitating immediate surgical intervention. Radiologists must be equipped with the knowledge to recognize subtle yet crucial imaging findings from UGI and CT scans to ensure timely intervention, thus mitigating the risks associated with this underreported acute complication of LSG and ultimately improving patient outcomes and safety.

Keywords: Bariatric surgery; Gastrectomy; Hernia; Hiatal hernia; Laparoscopy; Postoperative complications.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods
  • Humans
  • Laparoscopy* / methods
  • Obesity, Morbid* / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome