Endoscopic Treatment of Gastric Fundus Fistula after Sleeve Gastrectomy: A Case Report

Introduction: Gastric fistulas post sleeve gastrectomy is one of the most severe complications and can be found up to 5,3%. Surgical therapies to persistent gastric fistulas are technically difficult and sometimes inefficient. Therefore, new endoscopic techniques have been increasingly being researched in order to treat this surgical complication. Our study aims to describe a case report which the patient presented a gastric fistula post SG. This complication was treated by endoscopic approach. Case report: A 39 year old caucasian male underwent videolaparascopiccholecistechtomy and SG, in April 2012 in a large hospital in Curitiba. Regarding the pre operation evalution, the patient presented a BMI of 50.15 associated with hepatic steatosis and cholelithiasis. In the 43th day PO, an upper endoscopic was performed and visualized and gastric fistula of 0.5 cm in proximal anterior wall, right above the cardia. Four upper endoscopies were performed in order to reduce the fistula. The procedure was successful and the fistula was completely closed. Conclusion: The upper digestive endoscopy represents a reliable and effective method not only to diagnose but also to treat possible complication, even when they occur in infrequent anatomic areas like the one we presented in this case report.