Drain erosion and gastro-jejunal fistula after one-anastomosis gastric bypass: endoscopic occlusion by fibrin sealant.
Leakage and fistula are feared complications after gastro-intestinal anastomosis. A 36-year-old female underwent an one-anastomosis gastric bypass. The 24-h routine radiological study before oral intake showed a tiny leak, which was treated by NPO and I.V. fluids. After 5 days, despite output reduction, total parenteral nutrition was commenced. After 8 days, the leak remained with reduced output. It was then occluded endoscopically by fibrin glue. To our surprise, we found the drain that we had left behind the anastomosis, inside the gastric pouch. We began withdrawing the drain and occluded the defect with 4 ml Tissucol. After 48-h of no output, a repeat radiological study showed persistence of the leak. 6 days later, a radiological study demonstrated total closure of the leak.
Garcia-Caballero
Manuel
M
Department of Surgery, University Malaga, Spain. gcaballe@uma.es
Carbajo
Miguel
M
Martinez-Moreno
José Manuel
JM
Sarria
Manuel
M
Osorio
Diego
D
Carmona
Jose-Antonio
JA
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D015390:Gastric Bypass / Q000379:methods*; D005773:Gastroscopy; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000628:therapy*; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000628:therapy*
D015718:Fibrin Tissue Adhesive