Conservative management of an unusual bilioduodenal fistula post laparoscopic Duodeno-Ileal Switch (SADI-S) case report.
BACKGROUND
Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is an advanced operation for morbid obesity. To our knowledge, no internal Biliodigestive Fistula has yet been reported as specific complication in the field of metabolic and bariatric Biliopancreatic diversion.


METHODS
In this case report, we detail the case of a 57-year-old man who underwent a Single Anastomosis Duodeno-Ileal Switch (SADI-S) bariatric procedure for morbid obesity. Upon admission 3 weeks after the SADI-S procedure acute sepsis caused by a delayed choledoco-duodenal Fistula was diagnosed. A conservative management of this rare complication was successful.


CONCLUSIONS
We highlight the differential diagnosis and optional treatment in such a rare complication, and how we succeeded in its conservative management, without any need for endoscopic nor surgical intervention. A review of the literature on different types of Internal Biliodigestive Fistulae and their appropriate management are reported and briefly discussed.


CONCLUSIONS
The aim of this case report is to highlight the existence of such a rare complication, and its successful multidisciplinary conservative medical management.
University Hospital of Notre Dame des Secours, Affiliated To FMSM at USEK, Université St Esprit Kaslik, Byblos, Lebanon. Electronic address: cheli@skynet.be.
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Chelala
University Hospital of Notre Dame des Secours, Affiliated To FMSM at USEK, Université St Esprit Kaslik, Byblos, Lebanon.
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Adam
University Hospital of Notre Dame des Secours, Affiliated To FMSM at USEK, Université St Esprit Kaslik, Byblos, Lebanon.
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Rizk
University Hospital of Notre Dame des Secours, Affiliated To FMSM at USEK, Université St Esprit Kaslik, Byblos, Lebanon.
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Makhoul
Bilioduodenal fistula; Choledocoduodenal fistula; Internal biliodigestive fistula; Laparoscopic duodenal switch; SADI-S