Endoscopy 2019; 51(04): S69
DOI: 10.1055/s-0039-1681373
ESGE Days 2019 oral presentations
Friday, April 5, 2019 14:30 – 16:30: Video Motility South Hall 1B
Georg Thieme Verlag KG Stuttgart · New York

GASTRIC POEM TO TREAT INCISURA ANGULARIS TORSION AFTER SLEEVE GASTRECTOMY

A Baptista
1   Hospital de Clinicas Caracas, Caracas, Venezuela
,
M Dávila
1   Hospital de Clinicas Caracas, Caracas, Venezuela
,
M Guzman
1   Hospital de Clinicas Caracas, Caracas, Venezuela
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Gastric torsion is and uncommom complication after sleeve gastrectomy leading to food intolerance and abdominal pain. The stablished treatment is surgical adhecens resolution. Achalasia baloon dilatation or stenting has been describedWe present acalinical case of a patient with gastric torsion after 6 months of sleeve gastrectomy unresponsive to endoscopic treatment.

Methods:

The proposed treatment was to perform a gastric POEM to cut the adhecens through a gastric submucosa tunnel. The critical area was incisura angularis. Submucosal long tunnel was confectioned from 8 cms above critical area. Total tunnel lenght was 14 cms. Suture gastric line scar tissue was liberated from submucosa and gastric muscle with a endoscopic knife entering peritoneal cavity.

Results:

Resolution of the restriction was inmediatly achived. Mucosotomy was close with clips. Evolution was excelent. The patient was discharged from the hospital 1 day after with peroral clear liquids. Diet was advanced to solid after 5 days. No adverse event ocurred. Follow up is 10 months and the patient remains asymptomatic.

Conclusion:

GPOEM could be considered as an alternative rescue therapy for gastric torsion after sleeve gastrectomy.