A very challenging case:
42 years old morbidly obese female, underwent VBG procedure 5 years ago. She started to complain of recurrent vomiting and weight regain.
CT virtual gastroscopy revealed a stenotic area at site of previous stapling with pouch enlargement causig a conseidrable paraesophageal hiatus hernia.
this explain the cause of recurrent vomiting and alteration in her diet behaviour to become a sweet eater.
reduction of hiatal content with repair was done and conversion to OAGB.