Excellent weight result after Roux-en-Y gastric bypass in spite of gastro-gastric fistula.
A male patient (age 37 years, BMI 38 kg/m(2)) underwent a revisional gastric bypass after failed gastric banding. Unfortunately he developed a leak from the proximal pouch and subsequently a gastro-gastric fistula between the pouch and the main stomach. He recovered fully and could eat and drink without any restriction. Repeat examination with x-ray and endoscopy revealed that the fistula remained widely open. Remarkably, the patient lost weight to a BMI of 27 kg/m(2) (ie. lost 80% of his original excess body weight), thus challenging the widely held opinion that gastro-gastric fistulas inevitably lead to poor weight loss. In our patient the weight loss was stable for 2 years, when the fistula was closed surgically to avoid chronic proton pump inhibitor medication for stomal ulcer.
Gustavsson
Sven
S
Department of Surgery, University Hospital, Uppsala, Sweden. Sven.Gustavsson@kirurgi.uu.se
Sundbom
Magnus
M
D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D015992:Body Mass Index; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D005747:Gastric Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss