Presentation
History of gastric sleeve five months ago, presenting with severe non-bilious vomiting, anorexia, and epigastric pain.
Patient Data
Moderately dilated esophagus with contrast stasis along with the CT study phases.
Postoperative changes related to sleeve gastrectomy with a moderately dilated proximal gastric body showing gas/contrast level. It abruptly terminates at the mid/lower gastric body portion where a spiral gastric configuration is noted. No evidence of complete obstruction with the enteric contrast passing distally opacifying the distal stomach, gastric antrum, duodenum, and the small bowel loops.
Case Discussion
The above described esophagogastric CT findings are suggestive of partial gastric obstruction with a suspected level at the mid/lower gastric body suggesting a picture of a twisted gastric sleeve.