Gastrobronchial fistula a rare complication post laparoscopic sleeve gastrectomy
A 30-year-old male patient with morbid obesity underwent a laparoscopic sleeve gastrectomy in another hospital. During the post-operative course, the patient experienced abdominal pain and vomiting. An upper gastrointestinal contrast study was performed, which showed gastric leak and left subphrenic collection. The patient underwent percutaneous drainage of the left subphrenic collection, and was discharged home after improvement with oral antibiotic.\nAbout 4 months later, the patient was referred to our hospital. He had persistent cough with yellowish sputum, which aggravated with drinking, and on and off fever for 3 weeks. Physical examination was unremarkable. Chest radiograph was performed and showed elevated left hemidiaphragm with basal atelectasis otherwise unremarkable. An upper gastrointestinal contrast study was performed, which showed gastric leak, subphrenic collection, and gastrobronchial fistula [ and ].\nThe patient was managed conservatively with wide-spectrum antibiotic, CT-guided percutaneous drainage of the left subphrenic collection, endoscopic covered stent of gastric fistula and nasojejunostomy feeding. The patient was discharged home after clinical improvement, with a surgical outpatient clinic appointment.