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Journal article
Gastropleural Fistula: A Rare Complication of a Common Procedure
CUREUS JOURNAL OF MEDICAL SCIENCE, v 11(2), e4136
26 Feb 2019
PMID: 31058019
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Weight loss surgeries are evident to be highly beneficial in patients with morbid obesity (body mass index (BMI) >= 40.0 kg/m(2)) and severe obesity (BMI between 35.0 and 39.9 kg/m(2 )with co-morbidities). While this results in significant mortality benefit, there is always the possible risk of postsurgical complications. Gastrobronchial and gastropleural fistulas are two rare, post-operative pulmonary complications associated with these surgeries. Our patient is a 54-year-old female who underwent a biliopancreatic diversion with a duodenal switch. A few weeks later, she started developing a cough, fever, and shortness of breath. Computed tomography (CT) chest showed the presence of a loculated right sided hydropneumothorax. A gastrointestinal fluoroscopic contrast study performed showed a large fistula originating from the distal end of the stomach and ending towards the right pleural cavity. The fistula was successfully closed with the endoscopic fulguration of fistulous opening with argon beam coagulation and orthoscopic clipping, resulting in complete obliteration of the fistula tract. The right-sided hydropneumothorax was initially treated conservatively with antibiotics and chest tube drains followed by video-assisted thoracoscopic decortication with chest tube placement. Gastropleural fistula formation is rare but is nonetheless a serious postoperative complication of bariatric procedures and mimics pneumonia clinically. It is, therefore, essential to obtain detailed imaging work-up to rule out fistula formation, which, in turn, can be timely treated without causing further devastating results to the patient.
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Details
- Title
- Gastropleural Fistula: A Rare Complication of a Common Procedure
- Creators
- Shumaila M Iqbal - Sisters of Charity HospitalCassandra Zhi - Internal Medicine, University at Buffalo / Sisters of Charity Hospital, Buffalo, USA Internal Medicine, Drexel University College of Medicine, Philadelphia, USA Internal Medicine, Hackensack Meridian School of Medicine at Seton Hall University, Trenton, USA Internal Medicine, Jinnah Sindh Medical University, Karachi, PAKMawra Masud - Sisters of Charity HospitalHafiz M Aslam - Internal Medicine, University at Buffalo / Sisters of Charity Hospital, Buffalo, USA Internal Medicine, Drexel University College of Medicine, Philadelphia, USA Internal Medicine, Hackensack Meridian School of Medicine at Seton Hall University, Trenton, USA Internal Medicine, Jinnah Sindh Medical University, Karachi, PAKMadiha A Qadir - Jinnah Sindh Medical University
- Publication Details
- CUREUS JOURNAL OF MEDICAL SCIENCE, v 11(2), e4136
- Publisher
- SPRINGERNATURE; LONDON
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000462054400002
- Other Identifier
- 991021860814804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Surgery