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Revista Científica do Hospital e Maternidade José Martiniano de Alencar

Relato de Caso

Vol. 5 No. 1 (2024)

Gastric Torsion after Vertical Sleeve Gastroplasty: A Case Report

DOI
https://doi.org/10.54257/2965-0585.v5.i1.112
Submitted
July 12, 2026
Published
2026-09-17

Abstract

Sleeve gastrectomy is currently one of the most frequently performed bariatric procedures and, although considered safe, may be complicated by mechanical problems such as functional stenosis due to gastric tube torsion. We report the case of a patient who underwent sleeve gastrectomy and developed persistent obstructive symptoms, including nausea, postprandial vomiting and food intolerance. Upper endoscopy and contrast radiography demonstrated torsion of the gastric sleeve at the incisura angularis, consistent with functional gastric stenosis after sleeve gastrectomy. The patient was treated with two sessions of endoscopic balloon dilation, with progressive resolution of symptoms, no procedure-related complications and no need for revisional surgery. This case highlights the importance of early recognition of gastric torsion as a cause of functional stenosis after sleeve gastrectomy and supports endoscopic balloon dilation as an effective, minimally invasive therapeutic option in selected patients.

References

  1. Costa MN, Capela T, Seves I, Ribeiro R, Rio-Tinto R. Endoscopic Treatment of Early Gastric Obstruction After Sleeve Gastrectomy: Report of Two Cases. GE Portuguese Journal of Gastroenterology. 2015 Sep 12;23(1):46–9. DOI: 10.1016/j.jpge.2015.07.008 DOI: https://doi.org/10.1016/j.jpge.2015.07.008
  2. Elsebaey MA, Enaba ME, Elashry H, Elrefaey W, Hagag RY, Shalaby NA, et al. The Efficacy and Safety of Endoscopic Balloon Dilatation in the Treatment of Functional Post-Sleeve-Gastrectomy Stenosis. Medicina (Kaunas, Lithuania). 2024;60(5):833. DOI: 10.3390/medicina60050833. DOI: https://doi.org/10.3390/medicina60050833
  3. Siqueira LT, Santa-Cruz F, Pontual JP, Aquino MAR, Dompieri LT, Kreimer F, et al. Bariatric twist after sleeve gastrectomy: a proposal for endoscopic classification. Arq bras cirdig. 2022 jun 24;35:e1665. doi: 10.1590/0102-672020210002e1665. DOI: https://doi.org/10.1590/0102-672020210002e1665
  4. Abd Ellatif ME, Abbas A, El Nakeeb A, Magdy A, Salama AF, Bashah MM, et al. Management Options for Twisted Gastric Tube after LaparoscopicSleeve Gastrectomy. Obes Surg. 2017 Sep;27(9):2404-2409. doi:10.1007/s11695-017-2649-y. DOI: https://doi.org/10.1007/s11695-017-2649-y
  5. Sarno G, Calabrese P, Tramontano S, Schiavo L, Pilone V. Twisted Gastric Tube afterLaparoscopic Sleeve Gastrectomy-An Unusual but Effective Surgical Approach to AchieveFull Recovery. J Clin Med. 2022 Apr 20;11(9):2304. doi: 10.3390/jcm11092304. DOI: https://doi.org/10.3390/jcm11092304
  6. Subhas G, Gupta A, Sabir M, Mittal VK. Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy. World J Gastrointest Surg.2015 Nov 27;7(11):345-8. doi: 10.4240/wjgs.v7.i11.345 DOI: https://doi.org/10.4240/wjgs.v7.i11.345
  7. Ogra R, Kini GP. Evolving endoscopic management options for symptomatic stenosis post-laparoscopic sleeve gastrectomy for morbid obesity: experience at a large bariatricsurgery unit in New Zealand. Obes Surg. 2015 Feb; 25(2):242-8. doi:10.1007/s11695-014-1383-y. DOI: https://doi.org/10.1007/s11695-014-1383-y

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