Gastroesophageal junction leak with serious sepsis after gastric bypass: successful treatment with endoscopy-assisted intraluminal esophageal drainage and self-expandable covered metal stent.
We present a case of gastroesophageal junction leak after gastric bypass with serious sepsis and hemodynamic instability. Minimally invasive treatment was performed in two stages: initial sepsis control by lavage and endoscopy-assisted laparoscopic placement of an intraluminal esophageal drainage tube through the leak orifice; this was followed by definitive leak treatment with a self-expandable covered metal stent after achieving hemodynamic stability. Patient evolution was satisfactory without the need for open surgery.
Department of General Surgery, Hospital Universitario de Canarias, 38320 La Laguna, S/C de Tenerife, Canary Islands, Spain. ammalagon@hotmail.com
Antonio
A
Martin-Malagon
Ivan
I
Arteaga-Gonzalez
Lucrecia
L
Rodriguez-Ballester
Francisco
F
Diaz-Romero
D004937:Esophageal Fistula / Q000209:etiology / Q000601:surgery; D004943:Esophagogastric Junction / Q000293:injuries* / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D005747:Gastric Fistula / Q000209:etiology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D018805:Sepsis / Q000209:etiology / Q000601:surgery; D015607:Stents; D016896:Treatment Outcome