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Emergency Sleeve Gastrectomy as Rescue Treatment for Acute Gastric Necrosis Due to Type II Paraesophageal Hernia in an Obese Woman with Gastric Banding
Authors:Paolo Bernante  Cristiano Breda  Fabio Zangrandi  Fabio Pomerri  Maria Rosa Pelizzo  Mirto Foletto
Affiliation:(1) Istituto di Patologia Speciale Chirurgica, Policlinico Universitario, Università di Padova, Via Giustiniani 2, Padua, 35128, Italy;(2) Chirurgia Toracica, Università di Padova, Padua, Italy;(3) Istituto di Radiologia, Università di Padova, Padua, Italy;(4) Clinica Chirurgica II, Università di Padova, Padua, Italy
Abstract:
A morbidly obese 42-year-old woman presented with a 1-week history of left chest pain. She had undergone laparoscopic adjustable gastric banding 16 months earlier with a body mass index (BMI) of 49.2 kg/m2. Diagnostic workup revealed a large left pleural empyema and ruled out band slippage. At left thoracotomy, a misdiagnosed type II paraesophageal strangulated hernia with gastric necrosis and large perforation of the fundus was evident. At laparotomy, the band was removed, the stomach was reduced into the abdomen, and a sleeve gastrectomy was performed. Her postoperative course was uneventful, and 6 months after surgery, her BMI is 31 kg/m2. Emergency sleeve gastrectomy could represent a good option to treat, at the same time and in a safe way, both gastric necrosis and paraesophageal hernia, improving the good results in terms of weight loss after gastric restriction from gastric banding.
Keywords:Morbid obesity  Bariatric surgery  Laparoscopic gastric banding  Paraesophageal hernia  Strangulation
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