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Obesity Surgery

, Volume 19, Issue 2, pp 261–264 | Cite as

Case Report—Complex Management of a Postoperative Bronchogastric Fistula After Laparoscopic Sleeve Gastrectomy

  • David Fuks
  • Frederic Dumont
  • Pascal Berna
  • Pierre Verhaeghe
  • Raphael Sinna
  • Charles Sabbagh
  • Fabien Demuynck
  • Thierry Yzet
  • Richard Delcenserie
  • Eric Bartoli
  • Jean-Marc RegimbeauEmail author
Case Report

Abstract

Laparoscopic sleeve gastrectomy (LSG) is a new restrictive bariatric procedure increasingly indicated in the treatment of morbid obesity. Postoperative complications are mainly represented by gastric fistula with an occurrence rate of 0% to 5.1% in the literature. This complication is difficult to manage and requires multiple radiological, endoscopic, and surgical procedures. We report herein the case of a 23-year-old woman who underwent LSG for morbid obesity. This patient was reoperated for peritonitis due to a gastric fistula located on the top of the staple line. Five months later, she complained of a cough with fever and expectoration. A methylene blue test and a computed tomography scan diagnosed a postoperative bronchogastric fistula. After failure of aggressive conservative management, radical surgery was performed with total gastrectomy, reconstruction of the diaphragm using the extended latissimus dorsi flap, and a pulmonary lobectomy. This case report highlights the possible issue of the complex management of gastric fistula after LSG.

Keywords

Laparoscopic sleeve gastrectomy Postoperative gastric fistula Bronchogastric fistula Endoscopic management Extended surgery 

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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • David Fuks
    • 1
  • Frederic Dumont
    • 1
  • Pascal Berna
    • 2
  • Pierre Verhaeghe
    • 1
  • Raphael Sinna
    • 3
  • Charles Sabbagh
    • 1
  • Fabien Demuynck
    • 4
  • Thierry Yzet
    • 4
  • Richard Delcenserie
    • 5
  • Eric Bartoli
    • 5
  • Jean-Marc Regimbeau
    • 1
    Email author
  1. 1.Department of Digestive Surgery, Amiens North HospitalUniversity of PicardyAmiensFrance
  2. 2.Department of Thoracic Surgery, Amiens North HospitalUniversity of PicardyAmiensFrance
  3. 3.Department of Plastic Surgery, Amiens North HospitalUniversity of PicardyAmiensFrance
  4. 4.Department of Radiology, Amiens North HospitalUniversity of PicardyAmiensFrance
  5. 5.Department of GastroenterologyAmiens North Hospital, University of PicardyAmiensFrance

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