A rare case report of late-onset phytobezoar formation following laparoscopic sleeve gastrectomy: delayed redo bariatric surgery

Abstract

Background: Phytobezoar formation is a complication of bariatric surgery and mostly occurs after laparoscopic Roux-en-Y gastric bypass (LRYGB) operations. Here, we present an extremely rare case of late phytobezoar formation following laparoscopic sleeve gastrectomy (LSG). Case presentation: A 52-year-old woman with a body mass index (BMI) of 40.7 kg/m2 underwent LSG. Following persistent symptoms of nausea, vomiting, early satiety, and tremendous weight loss, endoscopy was performed, and gastric phytobezoar was detected at one-year post-operation. After endoscopic fragmentation, phytobezoar was removed by snare, and the patient later underwent redo bariatric surgery (conversion of LSG to LRYGB). Conclusions: With an increase in the number of LSG procedures performed globally, and the late-onset nature of phytobezoar formation, more cases of this complication are expected to be detected in future. Long-term postoperative follow-up alongside applying surgical methods to avoid gastric stenosis are needed to reduce the chance of phytobezoar formation in patients undergoing LSG.