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Description keyboard_arrow_down
Gastro-gastric fistula is an uncommon complication of gastric bypass (both Roux-en-Y and single anastomosis). Its symptoms range from none (if the fistula is small) to severe (if the fistula is significant). Severe symptoms include: invalidating gastroesophageal reflux (GERD), and failure to lose weight. The treatment can be postponed when symptoms are mild, but more often than not, revisional surgery needs to be considered. Despite several isolated reports on success with endoscopic treatment, state-of-the-art treatment currently still consists of (laparoscopic) revisional surgery. This case is the laparoscopic revision of such a gastro-gastric fistula after a Roux-en-Y gastric bypass.

CASE RECORD


Clinical Case:

  • The patient is a 56-year-old man
  • 23.3 kg, 183 cm, BMI 37
  • Current problem: weight regain, Acid reflux ++

Bariatric History:

  • 2005: Lap gastric banding
  • 2013: Lap conversion to gastric bypass

Other history:

  • Open appendectomy, hernia repair with mesh, atrial fibrilation (ablation), asthma, gall stones
  • Co-morbidity: hypertension, refluxoesophagitis, dyspnea, back pain, psychological problems
  • Medication: PPI 2 x 40 mg/d, Sevikar
  • Lab: Vit D 16 µg/L
  • Daily calory intake: 1649 kcal/d
Faculty keyboard_arrow_down
Dr. Jacques Himpens IFSO Senior Past President, Chief bariatric unit, CHIREC Hospitals, Attending surgeon, Saint Pierre university hospital, Brussels, Belgium Bariatric Surgery
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