Differential Diagnosis for Sudden Short-Lived Nausea and Vomiting 9 Days After Sleeve Gastrectomy
- Single Most Likely Diagnosis
- Post-operative ileus or gastritis: This is a common issue after sleeve gastrectomy due to the manipulation of the stomach and the potential for inflammation or temporary cessation of normal bowel movements.
- Other Likely Diagnoses
- Stenosis or narrowing of the sleeve: This could cause obstructive symptoms leading to nausea and vomiting, especially if the narrowing is significant enough to impede the normal flow of food.
- Adhesions: Early adhesions could form after surgery, potentially causing bowel obstruction, which might manifest as nausea and vomiting.
- Infection: Post-surgical infection could cause nausea and vomiting among other symptoms such as fever and abdominal pain.
- Do Not Miss Diagnoses
- Leak from the staple line: Although less likely, a leak is a serious complication that can lead to peritonitis and sepsis. Nausea and vomiting could be early signs, along with abdominal pain and fever.
- Pulmonary embolism: A significant risk after any major surgery, pulmonary embolism can present with nausea and vomiting, especially if there is associated hypoxia or pain.
- Bowel obstruction: This could be due to various causes including internal hernias, which are a known complication after sleeve gastrectomy.
- Rare Diagnoses
- Marginal ulcer: Although rare, especially if the patient is not taking NSAIDs or has not been diagnosed with H. pylori, a marginal ulcer could cause nausea and vomiting, especially if it leads to bleeding or perforation.
- Intussusception: A rare condition where a part of the intestine telescopes into another, which could potentially cause obstructive symptoms.
- Gastric remnant volvulus: If a portion of the stomach was left intact during the surgery, it could potentially twist, leading to ischemia and symptoms including nausea and vomiting.