title: Case report-complex management of a postoperative bronchogastric fistula after laparoscopic sleeve gastrectomy.
abstract: Laparoscopic sleeve gastrectomy (LSG) is a new restrictive bariatric procedure increasingly indicated in the treatment of morbid obesity. Postoperative complications are mainly represented by gastric fistula with an occurrence rate of 0% to 5.1% in the literature. This complication is difficult to manage and requires multiple radiological, endoscopic, and surgical procedures. We report herein the case of a 23-year-old woman who underwent LSG for morbid obesity. This patient was reoperated for peritonitis due to a gastric fistula located on the top of the staple line. Five months later, she complained of a cough with fever and expectoration. A methylene blue test and a computed tomography scan diagnosed a postoperative bronchogastric fistula. After failure of aggressive conservative management, radical surgery was performed with total gastrectomy, reconstruction of the diaphragm using the extended latissimus dorsi flap, and a pulmonary lobectomy. This case report highlights the possible issue of the complex management of gastric fistula after LSG.
authors.affiliation: Department of Digestive Surgery, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: David
authors.initials: D
authors.lastname: Fuks
authors.affiliation: Department of Digestive Surgery, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Dumont
authors.affiliation: Department of Thoracic Surgery, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Berna
authors.affiliation: Department of Digestive Surgery, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Verhaeghe
authors.affiliation: Department of Plastic Surgery, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Raphael
authors.initials: R
authors.lastname: Sinna
authors.affiliation: Department of Digestive Surgery, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Sabbagh
authors.affiliation: Department of Radiology, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Demuynck
authors.affiliation: Department of Radiology, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Yzet
authors.affiliation: Department of Gastroenterology, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Delcenserie
authors.affiliation: Department of Gastroenterology, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Bartoli
authors.affiliation: Department of Digestive Surgery, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods; D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D004396:Coloring Agents; D003287:Contrast Media; D003964:Diaphragm / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D005747:Gastric Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008168:Lung / Q000601:surgery; D008751:Methylene Blue; D009767:Obesity, Morbid / Q000601:surgery; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D004396:Coloring Agents; D003287:Contrast Media; D008751:Methylene Blue