Gastro-colo-diaphragmatic fistula after sleeve gastrectomy

Int J Surg Case Rep. 2021 Feb:79:394-397. doi: 10.1016/j.ijscr.2021.01.083. Epub 2021 Jan 22.

Abstract

Introduction: Postsleeve gastrectomy fistula is a serious complication, and its management remains quite challenging. The clinical presentation of chronic fistula after sleeve gastrectomy (SG) varies widely and depends on the type of fistula. Management requires a multidisciplinary approach and patient cooperation.

Case presentation: We present a case of a 41-year-old woman with a body mass index (BMI) of 46 kg/m2 who initially underwent laparoscopic sleeve gastrectomy in our hospital. Later, she developed a gastro-colo-diaphragmatic fistula (GCD), which was successfully treated using an endolaparoscopic approach. Follow-up imaging and endoscopy showed complete healing of the fistula, as well as a marked clinical improvement of the patient.

Discussion: Gastro-colo-diaphragmatic fistula following sleeve gastrectomy is an extremely rare complication. This is the first case of a GCD fistula after sleeve gastrectomy that has been reported in the literature.

Conclusion: One staged endolaparoscopic management was successful approach in our case and can be considered for complex gastric fistula following sleeve gastrectomy.

Keywords: Endo-VAC; Gastrocolophrenic fistula; Sleeve gastrectomy complication; Sleeve leak; fistula after sleeve gastrectomy.

Publication types

  • Case Reports