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. 2017:35:82-86.
doi: 10.1016/j.ijscr.2017.03.035. Epub 2017 Apr 4.

Gastropleural fistula after single anastomosis gastric bypass. A case report and review of the literature

Haider Al-Shurafa  1 , Saleh Alghamdi  2 , Ali Albenmousa  3 , Haifa Alolayan  2 , Zahraa Al-Shurafa  4
Affiliations

Gastropleural fistula after single anastomosis gastric bypass. A case report and review of the literature

Haider Al-Shurafa et al. Int J Surg Case Rep. 2017.

Abstract

Introduction: Pulmonary complications after bariatric surgeries are rare but usually serious. They often occur early after surgery but the presentation might be delayed for several months. Gastropleural fistula after bariatric surgery is extremely rare and has been reported in a very small number of patients post sleeve gastrectomy and gastric bypass.

Case presentation: A 37-year-old lady presented with left sided pleural effusion and empyema 2 years post single anastomosis gastric bypass surgery. She was found to have a large gastropleural fistula and was managed by surgical repair of the fistula with conversion to gastric bypass and decortication of the affected pleura. That resulted in significant clinical improvement and resolution of the empyema.

Conclusion: Gastropleural fistula is a very rare complication of bariatric surgeries and should be considered in patients who present with chronic or recurrent pulmonary infections.

Keywords: Bariatric surgery; Empyema; Gastropleural fistula; Minigastric bypass; Single anastomosis gastric bypass.

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Figures

Fig. 1
Fig. 1
CT scan for chest and abdomen showing air filled tract extending from gastric pouch to left pleural cavity.
Fig. 2
Fig. 2
Gastrografin study showing the leakage of orally administered contrast media from the upper part of stomach to the adjacent part of the left sub-phrenic collection.
Fig. 3
Fig. 3
Endoscopic view of the fistula opening below gastroesophageal junction and near to the anastomosis site.
Fig. 4
Fig. 4
Gastropleural fistula from the peritoneal side as appeared during laparoscopic exploration.
Fig. 5
Fig. 5
Gastropleural Fistula from the thoracic side as appeared during minithoracotomy.
See this image and copyright information in PMC

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