Gastric Sleeve Complications: What Does a Gastric Sleeve Leak Feel Like?

Gastric Sleeve Complications

Any type of surgery has associated risks, complications, and side effects. If you are contemplating having bariatric surgery for weight loss, it is important to understand the procedure, recovery, and be aware of the risks involved. Today we are talking about gastric sleeve side effects.

Is Gastric Sleeve Safe?

If you are contemplating gastric sleeve surgery you may be asking yourself, “What are the chances of dying from gastric sleeve surgery?”. In rare cases (0.08%), gastric sleeve surgery may result in life-threatening complications that require immediate medical attention so knowing the signs of these emergency situations could save your life.


Most surgical complications will take place in the first week so doctors want patients to remain diligent in monitoring themselves during this time. The most serious complications after bariatric surgery are bleeding and stomach leak which normally presents within the first 24 hours post-surgery. Complications of gastric sleeve surgery may include:

1. Bleeding

Bleeding is the most common complication usually occurring in the first 24 hours after surgery so patients are required to spend at least one night in the hospital. This bleeding is usually a slow bleed coming from the long line of staples used to close up the edge where the stomach has been removed. Excessive bleeding may require a blood transfusion or a longer hospital stay.

What Are The Symptoms Of Excessive Bleeding After Gastric Sleeve Surgery?

The symptoms of blood loss after gastric sleeve surgery include shortness of breath, dizziness (especially when standing up), a rapid pulse of more than 100 beats a minute, very little urine output, and a pale complexion. Blood in the stool is also a sign of internal bleeding however this will not normally show up for 24 to 48 hours.

2. Stomach Leak

Stomach leak after having gastric surgery is rare however, it is potentially life-threatening and requires immediate medical attention. It happens when a tear or a gap is created somewhere along the edge of the stomach where staples have been used to close it up.

This gap allows contents from the stomach to migrate into the abdominal cavity where it can cause a severe infection and lead to sepsis (septic shock). Sepsis is a reaction involving all body systems and their potential to shut down, multiple organ failure, low blood pressure, and potentially death.

The surgeon must be relied upon to consider all symptoms present in relation to when the surgery was performed to diagnose a leak. If a leak is suspected, the patient must undergo open surgery to repair the gap and remove leaked fluid from the abdomen. Normally the patient has to stay in intensive care and may need temporary dialysis, a ventilator, or medication to regulate blood pressure.

What Does a Gastric Sleeve Leak Feel Like?

The symptoms of stomach leak include dizziness, rapid heart rate, fever, shortness of breath, abdominal pain that continues to get worse, bloating of the abdomen, shoulder pain or pain in the left side of the chest, pale complexion, overall feeling ill, and like something is very wrong.

Diagnosing a stomach leak is tricky because there is no universal reliable test to ensure if there is a leak present. The symptoms are also similar to symptoms that occur because of other complications and sometimes symptoms may not be presenting.

If you are showing any of these symptoms, get checked out as soon as possible. If a stomach leak is present, time is critical and medical attention is needed immediately.

3. Deep Vein Thrombosis (Blood Clots)

Blood clots after surgery are rare and happen in fewer than 1% of patients. The risk with blood clots is they have the potential to break off and travel through the bloodstream to the lungs causing a decrease in blood flow. This potentially fatal complication is called a pulmonary embolism.

Many precautions are taken during surgery to alleviate the risk of blood clotting. Sometimes patients are given a short-acting blood thinner before surgery and medical devices are used to stimulate the legs during their operation. The best defense against blood clots is to keep the blood circulating as quickly after surgery as possible. That is why the medical staff insists patients get up and walk around as much as possible after an operation.

This is doubly important for obese patients as they are more at risk for blood clots in their legs than others. It is important if you undergo surgery that you are diligent in getting up and walking around as soon as you can after the procedure and as you continue to recover at home.

What Are The Symptoms Of Blood Clots?

The symptoms of blood clots can include swelling, discoloration of the skin, a section of skin that is warm to the touch, itchy skin, shortness of breath, chest pain, dizziness or fainting, increased heart rate, rapid pulse, nausea high fever, sweats, unexplained cough, pain where the clot is located such as arm, leg, calf, etc.

4. Abdominal Abscess After Gastric Sleeve Surgery

Developing an abdominal abscess after gastric sleeve surgery is a very rare complication. An abscess is a collection of pus caused by an infection located in a specific area within the abdomen. Typically it happens under the left diaphragm and can be diagnosed using a CT scan.

This does not usually require an additional operation and can be drained by the radiologist. Typically the patient stays in the hospital and receives antibiotic treatments until the infection causing abscess is eliminated.

Symptoms of Abdominal Abscess

The symptoms of an abdominal abscess will usually take longer to develop than an abdominal leak and will happen over time. Symptoms can include a rapid heart rate, a bloated abdomen which can be accompanied by vomiting and fever.

5. Incision Infection

Infections at the incision sites may happen and normally occur between 7 to 10 days after surgery. Typically treatment involves opening up the wound to clean it out, frequent dressing changes, and a series of antibiotics. Normally this is done outpatient and continued at home unless the patient has other complications.

Symptoms Of Wound Infection

A small amount of redness at the incision site is normal unless accompanied by other symptoms. If the incision site is red, warm, or hot, discharging, or oozing, it is most likely infected and needs to be treated. The patient may also have a fever.

In rare cases, patients may experience longer-term issues after gastric sleeve surgery. These issues may present at any time after the procedure. These include:

6. Stenoses Complications

Stenosis can develop along the tapered tube of the stomach. This is a complication where a section of the stomach is blocked by excessive scar tissue (it may be only a few millimeters wide) so food can not get through. This can normally be treated with an endoscopy to open it back up or sometimes they use a balloon to widen the area. If neither of these options is successful, then more invasive dilatation techniques may be used.

Symptoms of Stenosis

A patient may be experiencing symptoms of stenosis if they were eating solid foods with no issues, but after a few weeks they could handle liquids but would vomit up solids. If left untreated it may eventually lead to an intolerance to soft foods and liquids as well.

7. Stomach Obstruction After Gastric Sleeve Surgery

Stomach blockage is a very rare complication and has only been documented in a few patients across the country. Because the surgery changes the size and shape of the stomach to a lateral tube and removes the normal attachments that keep it in place. It is possible for the stomach to twist or kink leading to a blockage. Normally conservative therapies are attempted to untwist the stomach or remove the kink, if these are unsuccessful surgery may be necessary.

Stomach Obstruction Symptoms

The symptoms of a stomach blockage are normally moderate-to-severe pain in the abdomen and/or vomiting.

Is There A Safer Alternative For Weight Loss Than Surgery?

For some patients, surgery may not be a viable option and others may wish to explore less invasive alternatives before they agree to undergo a surgical procedure. For these patients, endoscopic sleeve gastroplasty (ESG) may be exactly what they are looking for!

What Is Endoscopic Sleeve Gastroplasty?

Endoscopic sleeve gastroplasty (ESG) has proven to be a safe and effective non-surgical procedure that can help obese patients lose a significant amount of their excess weight.

ESG does not require any incisions and is not a surgery but an endoscopic procedure that is done through the patient’s esophagus. A small flexible hollow tube that has a tiny camera attached (an endoscope) is lowered down through the patient’s throat as well as a special device used to apply sutures.

During the procedure, the patient’s stomach is altered to resemble a small banana, and sutures are put into place to hold this shape. The sutures are administered in such a way that the resulting stomach is about 25% of its original size. The smaller stomach size helps the patient eat less during meals and also reduces the hunger pangs normally felt between meals.

Unlike gastric sleeve surgery or gastric bypass surgery, no part of the stomach is removed so the procedure can be reversed if necessary. The patient does not require a hospital stay and can return home the same day. The recovery time for ESG is only about 7-10 days compared to the 4-6 weeks necessary after surgery. If you are looking for help losing weight but are hesitant to undergo surgery, ESG may be the best alternative for you!

Endoscopic Sleeve Gastroplasty (ESG) or Accordion Procedure: Everything You Need to Know

Dr. Chris explains what Endoscopic Sleeve Gastroplasty (ESG) procedure is, how it is done, and what its benefits are.

Some complications of surgery are not foreseeable but is it important to understand that there are complications that can occur after having weight loss surgery and some of them can be life-threatening. It is critical that medical professionals are contacted if life-threatening symptoms are experienced.

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