| CASE REPORT |
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| Year : 2020 | Volume
: 8
| Issue : 1 | Page : 58-63 |
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Controlled fistula: A valid option for the management of post bariatric surgery leak
Mohammad Ezzedien Rabie1, Ahmad Al Hazmi1, Ismaeel El Hakeem1, Rifaat Shakik2, Asim Elias1, Abdulla Saad Al Qahtani1, Tarek Saeed Malatani3, Saeed Al Khiar1
1 Department of Surgery, Armed Forces Hospitals, Southern Region, Khamis Mushait, Saudi Arabia
2 Department of Gastroenterology, Armed Forces Hospitals, Southern Region, Khamis Mushait, Saudi Arabia
3 Department of Surgery, Faculty of Medicine, Umm Al Qura University, Mecca, Saudi Arabia
Correspondence Address:
Dr. Mohammad Ezzedien Rabie
Department of Surgery, Armed Forces Hospitals, Southern Region, Khamis Mushait
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ssj.ssj_45_20
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Currently, bariatric surgery procedures has witnessed an upsurge in its utilization to control obesity and its allied morbidities. However, gastric or anastomotic leak, though rare, is its most dreadful complication. In this report we describe the clinical course of a 41 year-old-male, with a body mass index of 41.6, who underwent open mini gastric bypass which was followed by leak. A second laparotomy was performed in which intraperitoneal drains were inserted and a feeding jejunostomy was constructed. This was followed by the insertion of a mega stent, along with the application of over the scope clip at the site of the leak. Few days later, he appeared in our hospital with manifestations of sepsis. Computerized tomography scan showed persistence of leak with a perisplenic collection. A third laparotomy was performed and after tedious dissection, the stent was found eroding through the site of gastrojejunostomy. The defect was closed over a T tube and the perisplenic collection was drained. The patient tolerated surgery well, but he developed wound infection with disruption. Conservative treatment was followed to create a controlled incisional hernia, to be dealt with later. After a lengthy hospital stay, radioloic studies showed cessation of the leak with no collection. T tube, drains and jejunostomy tube were removed in time and the patient was discharged in good condition for OPD follow-up. |
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