Hi. Thanks for your query. Noted the history and understood your concerns. Since Gastric sleeve was performed 3 years ago and you have developed symptoms of lower abdominal pain, vomiting just about a week the cause may not be relate to the old surgery. Hence the most probable cause is intestinal obstruction as you have severe pain in lower abdomen and vomiting. I would advise you the following: X-ray of abdomen in standing position. Ultrasound, better be CT scan of the abdomen. Clinical evaluation and examination by a General Surgeon to get a proper diagnosis. Get admitted as three days conservative treatment with nil orally, intravenous fluid and electrolytes may help to relieve the problems. If not go for surgical correction is needed.