Hour-Glass Stomach: A Case Report of a Rare Disease with Small Review of the Literature

Abstract

Hour-glass stomach, a rare anatomical variant characterized by a narrowed gastric segment, presents with significant clinical challenges, including postprandial pain, nausea, vomiting, and malnutrition. This report details two cases of hour-glass stomach and their surgical management. The first case involved a 58-year-old female presenting with persistent esophageal reflux and dyspepsia, initially treated with laparoscopic
sleeve gastrectomy, subsequently revised to a Roux-en-Y gastrojejunostomy due to delayed gastric emptying. The second case was a 28-year-old male who presented with a hiatal hernia, abdominal pain, and vomiting, and who underwent a combined laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in a single procedure. Both patients were diagnosed using radiographic imaging with water-soluble contrast. The surgical approach, combining sleeve gastrectomy to address the anatomical narrowing and Roux-en-Y bypass to improve gastric emptying, resulted in symptom resolution and no recurrence at 2-month follow-up. This case series highlights the efficacy of this surgical strategy in managing hour-glass stomach and emphasizes the
importance of radiographic imaging for diagnosis and postoperative assessment. Further studies with larger patient cohorts are needed to establish standardized treatment protocols and long-term outcomes.