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Obesity Surgery

, Volume 19, Issue 2, pp 265–268 | Cite as

Development of a Gastric Pouch-Aorto-Colic Fistula as a Complication of a Revisionary Open Roux-en-Y Gastric Bypass

  • Mario Raul Villalba
  • Mario Ramon VillalbaEmail author
Case Report

Abstract

A 45-year-old female presented with an enterocutaneous fistula and intraabdominal abscesses weeks after undergoing an open roux-en-y gastric bypass 20 years after a previous bariatric procedure. Initial management consisted of exploration with resection of the fistula, open abscess drainage, percutaneous drains, and culture-directed intravenous antibiotics. Months later, the patient developed a gastrocolic fistula and massive upper gastrointestinal bleeding from a gastro-aortic fistula. The patient underwent resection of the gastrocolic fistula followed by a damage control operation including a left thoracotomy with aortic cross-clamping for the gastro-aortic fistula. Final reconstruction necessitated an extra-anatomic opening in the diaphragm for creation of an intrathoracic esophagojejunostomy and marsupialization of the distal esophagus and gastric pouch with concomitant mucusectomy. This rare but devastating complication requires prompt surgical management. In the appropriate setting, a high suspicion must be maintained in order to act swiftly for the patient’s benefit

Keywords

Roux-en-Y gastric bypass Massive gastrointestinal bleed Gastro-aortic fistula Intraabdominal sepsis Gastrocolic fistula 

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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  1. 1.Department of General SurgeryWilliam Beaumont HospitalRoyal OakUSA
  2. 2.Surgical Critical CareWilliam Beaumont HospitalRoyal OakUSA
  3. 3.Royal OakUSA

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