• David Fuks, Frederic Dumont, Pascal Berna, Pierre Verhaeghe, Raphael Sinna, Charles Sabbagh, Fabien Demuynck, Thierry Yzet, Richard Delcenserie, Eric Bartoli, and Jean-Marc Regimbeau.
• Department of Digestive Surgery, Amiens North Hospital, University of Picardy, place Victor Pauchet, 80054 Amiens, France.
• Obes Surg. 2009 Feb 1; 19 (2): 261-4.

AbstractLaparoscopic sleeve gastrectomy (LSG) is a new restrictive bariatric procedure increasingly indicated in the treatment of morbid obesity. Postoperative complications are mainly represented by gastric fistula with an occurrence rate of 0% to 5.1% in the literature. This complication is difficult to manage and requires multiple radiological, endoscopic, and surgical procedures. We report herein the case of a 23-year-old woman who underwent LSG for morbid obesity. This patient was reoperated for peritonitis due to a gastric fistula located on the top of the staple line. Five months later, she complained of a cough with fever and expectoration. A methylene blue test and a computed tomography scan diagnosed a postoperative bronchogastric fistula. After failure of aggressive conservative management, radical surgery was performed with total gastrectomy, reconstruction of the diaphragm using the extended latissimus dorsi flap, and a pulmonary lobectomy. This case report highlights the possible issue of the complex management of gastric fistula after LSG.

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