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Case Reports
. 2024 Jun 19:12:2050313X241263445.
doi: 10.1177/2050313X241263445. eCollection 2024.

Attempted one anastomosis gastric bypass converted to a sleeve gastrectomy in an adult patient with asymptomatic intestinal malrotation: A case report

Umesh Jayarajah  1 , Kalaiyukan Sathasivam  1 , Sumudu Kumarage  2 , Thejana Wijeratne  1   3
Affiliations
Case Reports

Attempted one anastomosis gastric bypass converted to a sleeve gastrectomy in an adult patient with asymptomatic intestinal malrotation: A case report

Umesh Jayarajah et al. SAGE Open Med Case Rep. .

Abstract

Unexpected encounters during surgery for obesity such as midgut malrotation cause specific technical challenges to the surgeon. We present a rare case of asymptomatic complete intestinal malrotation midway during a one anastomosis gastric bypass procedure. A 62-year-old male with a body mass index of 49 kg/m2 and metabolic syndrome was planned for one anastomosis gastric bypass. A gastric tube was created along the lesser curvature. During the attempt to identify the suitable small bowel loop, an unexpected completely malrotated gut was noted. Due to the intraoperative difficulty in identifying the correct loop to anastomose to the gastric tube an intraoperative decision was taken to convert the procedure to a sleeve gastrectomy. The created gastric tube was re-anastamosed to distal stomach, and the redundant stomach was resected. Postoperative recovery was uneventful, and weight loss was satisfactory. Attempted one anastomosis gastric bypass converted to a sleeve gastrectomy was a successful bailout procedure.

Keywords: One anastomosis gastric bypass; bariatric surgery; case report; intestinal malrotation; sleeve gastrectomy.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Image showing ileocaecal junction (yellow arrow) and caecum were found in the left iliac fossa.
Figure 2.
Figure 2.
Image showing the proximal small bowel was encased into a cocoon (yellow arrow) in the right iliac fossa region.
Figure 3.
Figure 3.
Anastomosis of created gastric tube to distal stomach using an endo-GIA stapler (yellow arrow).
Figure 4.
Figure 4.
Image showing the gastric sleeve (blue arrow) and the proposed remnant stomach (green arrow).
Figure 5.
Figure 5.
Image showing the resected specimen.
See this image and copyright information in PMC

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