Sleeve gastrectomy may not be an appropriate weight loss operation in patients with diffuse idiopathic skeletal hyperostosis

Aim-background Diffuse idiopathic skeletal hyperostosis (DISH) is a common disease among obese patients, though not easily suspected in obesity surgery departments. Case report We present the case of a 40-year-old woman with morbid obesity (BMI of 43kgr/m2) and undiagnosed DISH who underwent a laparoscopic sleeve gastrectomy (LSG). Postoperatively, she presented serious dysphagia and failure to lose weight. Results The patient complained of severe dysphagia postoperatively, for solid foods and cooked meals in particular. A gastroscopy and upper gastrointestinal swallow radiographs did not show stenosis. Dysphagia led the patient to a high-calorie low-viscosity diet and inability to lose weight. Two years after the operation, the patient underwent radiography and MRI of the thoracic and lumbar spine due to chronic low back pain; the diagnosis of DISH was set by a rheumatologist. Conclusion Patients with DISH may not be good candidates for restrictive bariatric operations. Patients presenting to morbid obesity surgical departments require a full investigation of all possible underlying causes of obesity, including DISH.