Background

We present a 51-year-old woman with a history of diabetes mellitus type 2, gastroesophageal reflux disease, and obstructive sleep apnea who had undergone adjustable gastric band placement in 2006 and lost 120 pounds. Due to pregnancy, she had her band emptied, and she subsequently regained her weight to her previous BMI of 47. As a result of a band leak, the patient had it removed and was converted to a sleeve gastrectomy in 2016. She then lost and regained her weight and was eventually converted to a single anastomosis duodenal ileal bypass in 2020. Her post operative course was complicated by severe diarrhea refractory to medical management, with frequency amounting to 13 times daily, in addition to chronic bloating and abdominal discomfort; she presented to our clinic as a result. Preoperative endoscopy showed normal anatomy with no signs of bile reflux. A discussion was had with the patient about the risks of reversal, including further weight regain and the patient agreed to proceed with reversal. Preoperative EGD showed normal SADI anatomy. The patient was taken to the operating room and the SADI was reversed with no complication. A post-operative UGI was done showing now normal sleeve anatomy with no obstruction, and the patient was discharged. Within 1 week the patient was seen in clinic with significant improvement in her diarrhea and quality of life.