Arif Sardar Hassan, Mohammed Ayad Ahmad
Department of Surgery, College of Medicine, University of Duhok, Duhok, Kurdistan Region, Iraq.
J Surg Case Rep. 2019 Dec 23;2019(12):rjz353. doi: 10.1093/jscr/rjz353. eCollection 2019 Dec.
Obesity is defined as body mass index (BMI) greater than 30. Weight loss improves the quality of life and alleviates or even treats some obesity-related comorbidities with general improvement in the quality of life. Sleeve gastrectomy results in major reduction of the size of the stomach and decreases the sense of hunger due to various hormonal and neuronal pathways. A 31-year-old lady had BMI of 49 underwent sleeve gastrectomy. Three weeks after surgery, she presented with epigastric pain and vomiting with radiological signs of leak. Endoscopic esophageal stent placed with resultant improvement of the condition; after stent removal, she developed esophageal stricture diagnosed with barium study. The patient underwent repeated successful endoscopic dilatation. Leak and bleeding are the most serious complications after sleeve gastrectomy. Subclinical leak is treated with antibiotics, drainage of the collection and stent, critical patients need stenting with operative repair of the site of leak.
肥胖的定义是体重指数（BMI）大于30。体重减轻可改善生活质量，并减轻甚至治疗一些与肥胖相关的合并症，从而总体提高生活质量。袖状胃切除术可大幅减小胃的大小，并通过各种激素和神经途径降低饥饿感。一名31岁、BMI为49的女性接受了袖状胃切除术。术后三周，她出现上腹部疼痛和呕吐，影像学显示有渗漏迹象。放置了内镜食管支架，病情因此得到改善；支架取出后，她出现食管狭窄，经钡剂造影检查确诊。该患者接受了多次成功的内镜扩张治疗。渗漏和出血是袖状胃切除术后最严重的并发症。亚临床渗漏采用抗生素治疗、引流积液并放置支架，病情危急的患者需要放置支架并对渗漏部位进行手术修复。
