A “MacGiveric” Myotomy for a Gastric Bypass Conundrum

Abstract

Postprandial nausea and vomiting (N/V) following a gastric sleeve can be a common side effect after the procedure as the body adapts to the smaller size of the stomach. The management guidelines recommend having smaller but more frequent meals focused on protein, adequate and thorough chewing, and adequate fluid intake.  Risk factors can include the female sex as well as the amount of opioid medication used for postoperative pain. We present a case of an elderly man experiencing postprandial nausea and vomiting for years after his gastric sleeve procedure, found to have distorted anatomy upon EGD evaluation, requiring further endoscopic intervention.