Endoscopic gastric plication complications: early hemorrhagic event and late suture dehiscence. A two-case series

Endoscopic gastric plication (EGP), also known as endoscopic sleeve gastroplasty, is a minimally invasive bariatric procedure that reduces gastric volume through full thickness endoluminal suturing. It has demonstrated aiding weight loss and improvement in obesity-related comorbidities. It is considered safe, with low rates of severe adverse events, but early and long-term complications remain insufficiently characterized. We report two cases of EGP-related complications. The first case involves a 31-year-old woman who presented 2 years after the procedure with persistent dyspepsia and recurrent gain due to suture dehiscence, requiring conversion to Roux-en-Y gastric bypass with removal of gastric remanent. The second case describes a 24-year-old woman who developed an early postoperative hemorrhagic complication secondary to gastroepiploic vessel injury, requiring urgent surgical intervention. These cases illustrate potential EGP severe complications, ranging from early acute life-threatening events to late structural failure, emphasizing the importance of high suspicion, timely diagnosis and individualized management strategies.