<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background</bold>. Morbid obesity is an important cause of morbidity and mortality. Bariatric surgery is the best option to manage obesity. Vertical gastrectomy is safe and effective but sometimes complicate with hemorrhage, fistulas and stenosis. Fistulas can be solved by conventional surgery or interventional endoscopy.<bold>Case presentation</bold>. We describe a morbidly obese patient with vertical gastrectomy who developed complications after surgery. Immediately after surgery the patient developed sepsis. Upper gastrointestinal endoscopy excluded fistula. One month later a peri-gastric abscess developed due to a fistula orifice in the distal esophagus, treated with argon plasma and two double pigtail plastic stents placed endoscopically to drain the abscess. The stents were removed two weeks later and was placed a covered metallic stent in the distal esophagus. Six weeks later the metallic stent was removed and the orifice closed. Four months later the patient developed sepsis. Computer tomography revealed a subdiaphragmatic abscess and endoscopy revealed a 2 mm fistula orifice at the previous site, treated with argon plasma and two trough-the-scope clips that closed it. There were no further incidents after two years of follow-up.<bold>Conclusions</bold>. Early diagnosis and endoscopic approach can resolve these complications without the morbidity and increased mortality risk of surgical re-interventions.</abstract>

Background. Morbid obesity is an important cause of morbidity and mortality. Bariatric surgery is the best option to manage obesity. Vertical gastrectomy is safe and effective but sometimes complicate with hemorrhage, fistulas and stenosis. Fistulas can be solved by conventional surgery or interventional endoscopy.Case presentation. We describe a morbidly obese patient with vertical gastrectomy who developed complications after surgery. Immediately after surgery the patient developed sepsis. Upper gastrointestinal endoscopy excluded fistula. One month later a peri-gastric abscess developed due to a fistula orifice in the distal esophagus, treated with argon plasma and two double pigtail plastic stents placed endoscopically to drain the abscess. The stents were removed two weeks later and was placed a covered metallic stent in the distal esophagus. Six weeks later the metallic stent was removed and the orifice closed. Four months later the patient developed sepsis. Computer tomography revealed a subdiaphragmatic abscess and endoscopy revealed a 2 mm fistula orifice at the previous site, treated with argon plasma and two trough-the-scope clips that closed it. There were no further incidents after two years of follow-up.Conclusions. Early diagnosis and endoscopic approach can resolve these complications without the morbidity and increased mortality risk of surgical re-interventions.

Case Report: Endoscopic Management of Sleeve Gastrectomy Fistula

Gastroenterology Department, County Clinical Emergency Hospital, Craiova,

Gastroenterology and Hepatology Department, Universitary Hospital Santa Maria, Lisbon,

Microbiology department, University of Medicine and Pharmacy of Craiova,

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Case Report: Endoscopic Management of Sleeve Gastrectomy Fistula"}

Background. Morbid obesity is an important cause of morbidity and mortality. Bariatric surgery is the best option to manage obesity. Vertical gastrectomy is...

Case Report: Endoscopic Management of Sleeve Gastrectomy Fistula

Publié en ligne: 30 déc. 2016

Pages: 422 - 425

Reçu: 07 déc. 2015

Accepté: 04 nov. 2016

DOI: https://doi.org/10.1515/amma-2016-0049

Mots clés
sleeve gastrectomy, bariatric surgery, endoscopic treatment

© 2016 Roşu Alexandra Floriana et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Case Report: Endoscopic Management of Sleeve Gastrectomy Fistula

Publié en ligne: 30 déc. 2016

Pages: 422 - 425

Reçu: 07 déc. 2015

Accepté: 04 nov. 2016

DOI: https://doi.org/10.1515/amma-2016-0049

Mots cléssleeve gastrectomy, bariatric surgery, endoscopic treatment

© 2016 Roşu Alexandra Floriana et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Mots clés
sleeve gastrectomy, bariatric surgery, endoscopic treatment