title: Resolution of an esophageal leak and posterior gastric wall necrosis with esophageal self-expandable metal stents.
abstract: The use of weight reduction surgeries has increased over the years with a higher proportion of these surgeries being sleeve gastrectomies, this has been associated with some complications including staple line leaks. We report a 32-year-old male who had undergone a laparoscopic gastric band surgery and subsequently a laparoscopic sleeve gastrectomy, this was complicated by both an staple line leak at the gastroesophageal junction as well as a large (> 4 cm) posterior gastric wall defect due to gastric wall necrosis. We used two co-axially inserted self-expandable stents (SEMS) in the management of this patient, 5 stents were used over repeated endoscopy sessions and 20 wk. Both defects had resolved without the need for surgical intervention.This is the first reported case were SEMS are used for both a staple line leak as well as a gastric wall defect. We also review the literature on the use of SEMS in the management of leaks post weight reduction surgeries.
authors.affiliation: Majid A Almadi, Abdulrahman M Aljebreen, Division of Gastroenterology, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Majid A
authors.initials: MA
authors.lastname: Almadi
authors.forename: Abdulrahman M
authors.initials: AM
authors.lastname: Aljebreen
authors.forename: Fahad
authors.initials: F
authors.lastname: Bamihriz
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation*; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D018530:Gastric Stump / Q000473:pathology*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008670:Metals; D009336:Necrosis; D011474:Prosthesis Design; D015607:Stents; D017792:Surgical Stapling / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: Esophageal leak; Gastric necrosis; Laparoscopic sleeve gastrectomy; Self-expandable metal stents; Staple line leak; Stents