title: [Gastro-bronchial fistula major complication of sleeve gastrectomy].
abstract: BACKGROUND
  Gastrobronchial fistula is a rare complication in gastroesophageal surgical procedures. It is difficult to diagnose and handling is complex. Therefore, there have been developments for non-surgical alternatives to obliterate minor fistula mortality. Endoscopic treatment is an option for patients with small fistulas or in serious condition.
  
  
  METHODS
  A 38 year old woman with evidence of gastrobronchial fistula postoperated of gastric sleeve, diagnosed during the postoperative period due to clinical variegated was initially handled as infectious respiratory symptoms; once the fistulous path was established, the intention was to close the path using endoclips. However, adding hemopneumothorax, drainage tube placement and thoracotomy were required. It was decided to chose a prosthetic esophageal endoscopic management of polytetraflouroethylene and fibrin as last therapy, because the patient had systemic inflammatory response syndrome, with favorable response to endoscopic management.
  
  
  CONCLUSIONS
  Bariatric surgery has shown satisfactory results, however, the complexity of the procedure favors severe complications such as the present case. Gastrobronchial fistulas represent a diagnostic and therapeutic challenge, this is considering from a conservative management to endoscopic procedures, as in our patient.
  
  
  CONCLUSIONS
  Although gastrobronchial fistulas are a rare complication, the use of endoscopy in resolution should be a first class weapon in its management, since it offers a lower morbidity in a patient with habitual respiratory symptoms that are difficult to control, with satisfactory results in the medium and long term.
authors.affiliation: Servicio de Cirugía General, Departamento de Cirugía, Hospital Regional de Ciudad Madero de Petróleos Mexicanos, Ciudad Madero, Tamaulipas, México.
authors.forename: Luis Alberto
authors.initials: LA
authors.lastname: Guerrero-Silva
authors.affiliation: Servicio de Cirugía General, Departamento de Cirugía, Hospital Regional de Ciudad Madero de Petróleos Mexicanos, Ciudad Madero, Tamaulipas, México.
authors.forename: Servando
authors.initials: S
authors.lastname: López-García
authors.affiliation: Servicio de Cirugía General, Departamento de Cirugía, Hospital Regional de Ciudad Madero de Petróleos Mexicanos, Ciudad Madero, Tamaulipas, México.
authors.forename: Fernando
authors.initials: F
authors.lastname: Guardado-Bermúdez
authors.affiliation: Servicio de Cirugía General, Departamento de Cirugía, Hospital Regional de Ciudad Madero de Petróleos Mexicanos, Ciudad Madero, Tamaulipas, México.
authors.forename: Fernando Josafat
authors.initials: FJ
authors.lastname: Ardisson-Zamora
authors.affiliation: Servicio de Cirugía General, Departamento de Cirugía, Hospital Regional de Ciudad Madero de Petróleos Mexicanos, Ciudad Madero, Tamaulipas, México. Electronic address: amedina_us@hotmail.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Medina-Benítez
authors.affiliation: Servicio de Cirugía General, Departamento de Cirugía, Hospital Regional de Ciudad Madero de Petróleos Mexicanos, Ciudad Madero, Tamaulipas, México.
authors.forename: Fernando
authors.initials: F
authors.lastname: Corona-Suárez
mesh_terms: D000328:Adult; D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology*; D003951:Diagnostic Errors; D004322:Drainage; D004945:Esophagoscopy; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005743:Gastrectomy / Q000379:methods*; D005747:Gastric Fistula / Q000175:diagnosis / Q000209:etiology*; D006491:Hemothorax / Q000209:etiology / Q000601:surgery; D006801:Humans; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D019919:Prosthesis Implantation; D012141:Respiratory Tract Infections / Q000175:diagnosis; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology; D013908:Thoracotomy
chemical_list: D015718:Fibrin Tissue Adhesive
keywords: Fístula gastrobronquial; Gastric sleeve; Gastrobronquial fistula; Manga gástrica