Slipped Band with Necrotic stomach requiring conversion to a roux en y esophagojejunostomy.

Rana C Pullatt, MD, FACS, Shaina Eckhouse, MD

Medical University of South Carolina

This is a case that highlights the pitfalls of Medical Tourism in Bariatric Surgery. The patient had a band placed in Mexico 5 years ago and had no follow up and minimal weight loss. Patient had never been seen by an accredited Bariatric program in the US. The patient had increasing dysphagia for nearly 2 months and then started having cramping abdominal pain . She was seen by her internist 12 hours after her abdominal pain had started. The patient was then admitted and on work up a CT scan was obtained which showed pneumatosis in the wall of the stomach. Patient was referred to our hospital for emergent surgery. On laparoscopic exploration necrosis of the upper half of the stomach was confirmed from a slipped band. We Intitially tried to dissect below the left gastric artery to attemtpt to salvage a small gastric pouch, however it was evident that the stomach had necrosed all the way upto the ge junction. We performed a subtotal gastrectomy and a esophagojejunostomy. The esophagojejunostomy was performed with a hand assist technique using a 25 eea. We also placed a g tube in the remnant distal stomach. The patient did well and has had 45 pound weight loss with no complications 3 months out at the time of submsission of this abstract. This case captures what is an increasing problem in this country due to the burgeoning medical tourism industry.

Session: Video Channel Day 1

Program Number: V049

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