title: De novo hiatal hernia of the gastric tube after sleeve gastrectomy.
abstract: BACKGROUND
  Sleeve gastrectomy (SG) is a frequently used surgical procedure for the treatment of morbid obesity. Several complications of SG have been described; however, de novo hiatal hernia of the gastric tube, as a complication of SG, has not been described in the literature.
  
  
  METHODS
  Here, we report a case of a hiatal hernia 2 years after SG. In the case reported here, the hiatal hernia was associated with weight regain. The mechanisms responsible for the herniation of the pouch are difficult to identify. Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass is an effective treatment for this complication. Its management is safe and effective.
  
  
  CONCLUSIONS
  Obesity itself is an independent risk factor for hiatal hernia, found preoperatively in more than half of the morbidly obese patients. This predisposition is explained by higher intra-gastric pressure due to intra-abdominal or visceral fat, reduced inferior oesophageal sphincter pressure, and oesophageal motility problems.
  
  
  CONCLUSIONS
  To our knowledge, this is the first described case of hiatal hernia of the gastric tube after SG.
authors: Department of General Surgery, Archet 2 Hospital, University Hospital of Nice, Nice, France.
authors: Imed Ben
authors: IB
authors: Amor
authors: Department of General Surgery, Archet 2 Hospital, University Hospital of Nice, Nice, France.
authors: Tarek
authors: T
authors: Debs
authors: Department of Bariatric Surgery, CHU Nord Hospital, Jean Monnet University, Saint Etienne, France. Electronic address: Radwankassir42@hotmail.F.
authors: Radwan
authors: R
authors: Kassir
authors: Department of General Surgery, Archet 2 Hospital, University Hospital of Nice, Nice, France.
authors: Rodolphe
authors: R
authors: Anty
authors: Department of General Surgery, Archet 2 Hospital, University Hospital of Nice, Nice, France.
authors: Virginie Ben
authors: VB
authors: Amor
authors: Department of General Surgery, Archet 2 Hospital, University Hospital of Nice, Nice, France.
authors: Jean
authors: J
authors: Gugenheim
keywords: Bariatric surgery; Hiatal hernia; Laparoscopic complications; Sleeve gastrectomy