Gastrobronchial fistula: A rare complication after laparoscopic sleeve gastrectomy and its endoscopic management.

Abstract

Background: Bariatric surgery is considered the standard of care for morbid obese patients who failed conservative management. However, it's not free of complications. Gastrobronchial fistula (GBF) is one of complications that could be happened during the post-operative course that could be successfully managed either surgically or endoscopically. Case presentation: We present a case of 45 years old morbid obese female patient underwent gastric bypass surgery that was early complicated by gastric leakage that was managed endoscopically with OVESCO clipping. 6 years later, the patient presented with chest infection with coughing of food that was proved to be associated with gastrobronchial fistula. We applied OVESCO clips and closed the fistula and dilate the gastrojejunostomy due to very narrow gastrojejunostomy using a balloon 20 to 30 mm and dilatation was done several times. After that repeated the barium meal showed that the fistula was successfully closed. Conclusion: Gastrobronchial fistula is one of rare reported complications following bariatric surgery that could be successfully managed endoscopically through different strategies in a highly effective therapeutic option that help in shortening of the leakage healing time.