This 40 year old female patient had a history of an adjustable gastric band that was removed due to slippage. Her weight increased from 170 lbs (BMI 26) to 415 lbs (BMI 65) and was revised to a duodenal switch. The patient presented to us years later with intractable abdominal pain and severe diarrhea. Upper GI series, CT scan and EGD were all consistent with normal duodenal switch anatomy with no abnormalities noted. The patient was taken for laparoscopic exploration. Standard limb lengths were found. A hiatal hernia was repaired. The ileoileostomy was revised and proximalized to treat the diarrhea. Postoperatively the diarrhea abated, but the abdominal pain worsened. The patient was taken back to the operating room three months later for exploration and reversal of her duodenal switch. The small bowel anastomoses and duodenoduonostomy were created hand sewn in an end-to-end fashion. Postoperatively the patient's pain completely resolved. Unfortunately, she developed reflux and weight recidivism. The plan is now for possible conversion to gastric bypass.