Surgical Management of a Chronic Sleeve Gastrocolic Fistula with Near Total Gastrectomy and Roux-en-Y Reconstruction

Dugan, Nicholas; Nimeri, Abdelrahman

doi:10.1007/s11695-020-04689-9

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…Historically, GJCF have been described as an unusual complication secondary to peptic ulcer disease, Crohn's disease, and stomach and colon cancer [15] . Large bowel fistulas following bariatric surgery have been more frequently reported following sleeve gastrectomy (versus Roux-en-Y gastric bypass) in association with staple line leaks [17] , [18] . In our literature review, only one case report of a gastrocolic fistula and one case of a jejunocolic fistula following LRYGB have been published [13] , [19] .…”

Section: Discussionmentioning

confidence: 99%

Gastrojejunocolic fistula: case report of a rare late complication of laparoscopic Roux-en-Y gastric bypass and review of the literature

Gehle

Pullatt

Elias

2021

International Journal of Surgery Case Reports

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Introduction Laparoscopic Roux-en-Y gastric bypass (LRYGB) is known as the weight loss surgery to which other bariatric procedures are compared. While morbidity and mortality of this procedure are low, serious complications do exist which can be life-threatening and sometimes require surgical correction. Case presentation A 63-year-old woman underwent LRYGB outside of the United States, later complicated by biliary colic treated with cholecystectomy and upper gastrointestinal bleeding secondary to H. pylori -related ulcer at her gastrojejunostomy. Following adequate treatment of the patients marginal ulcer, the patient experienced several months of progressive severe abdominal pain, frequent vomiting and diarrhea, and unintentional weight loss refractory to pharmacologic therapy. The patient underwent multiple medical and endoscopic evaluations unrevealing of an organic cause of her symptoms. At presentation, the patient was found to be profoundly weak, dehydrated and malnourished with metabolic derangements and was subsequently diagnosed with a gastrojejunocolic fistula via upper endoscopy and radiography. We provided excluded stomach gastrostomy tube feeding to the patient for three months to improve the patients nutritional status before definitive surgical correction was successfully performed. Discussion Large bowel fistulas are a rare and highly morbid late complication following LRYGB and are likely secondary to marginal ulcers and/or instrumentation such as endoscopy. Surgery represents the definitive treatment. Conclusion LRYGB is typically a safe and effective intervention for obesity. Large bowel fistulas are rare complications following this surgery. We highlight difficulties in diagnosing and treating this condition.

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Section: Discussionmentioning

confidence: 99%

Gastrojejunocolic fistula: case report of a rare late complication of laparoscopic Roux-en-Y gastric bypass and review of the literature

Gehle

Pullatt

Elias

2021

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

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“…The incidence varies from 2.4% to 7% depending on the case [8][9][10]. Most leaks appear at the upper portion stalpe line, near the gastroesophageal junction or near the corner of His [11]. Burgos, et al [12] reported that 85.7% of leaks is at the level of the subcardial region and that only 14.3% are distal.…”

Section: Discussionmentioning

confidence: 99%