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KMID : 1038120220550010141
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Clinical Endoscopy
2022 Volume.55 No. 1 p.141 ~ p.145
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A Gastrobronchial Fistula Secondary to Endoscopic Internal Drainage of a Post-Sleeve Gastrectomy Fluid Collection
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Gkolfakis Paraskevas
Bureau Marc-Andre
Arvanitakis Marianna
Deviere Jacques
Blero Daniel
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Abstract
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A 44-year-old woman underwent sleeve gastrectomy, which was complicated by a leak. She was treated with two sessions of endoscopic internal drainage using plastic double-pigtail stents. Her clinical evolution was favorable, but four months after the initial stent placement, she became symptomatic, and a gastrobronchial fistula with the proximal end of the stents invading the diaphragm was diagnosed. She was treated with antibiotics, plastic stents were removed, and a partially covered metallic esophageal stent was placed. Eleven weeks later, the esophageal stent was removed with no evidence of fistula. Inappropriate stent size, position, stenting duration, and persistence of low-grade inflammation could explain the patient’s symptoms and provide a mechanism for gradual muscle rupture and fistula formation. Although endoscopic internal drainage is usually safe and effective for the management of post-laparoscopic sleeve gastrectomy leaks, close clinical and radiological follow-up is mandatory.
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KEYWORD
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bariatric endoscopy, endoscopy complications, endoscopic internal drainage, gastrobronchial fistula, sleeve gastrectomy
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