MANAGEMENT OF PROXIMAL SLEEVE LEAK WITH PERI-SPLENIC ABSCESS, GASTRO-BRONCHIAL AND GASTRO-COLONIC FISTULAE
Sherif Aly*, Ali Tavakkoli
Surgery, Brigham and Women's Hospital, Boston, MA
This is a 41-year-old woman with a history of a sleeve gastrectomy and re-sleeve in 2021 for weight regain, complicated by an early post-operative leak requiring exploration and drain placement. She had undergone multiple failed endoscopic approaches and presented to us with a chronic leak with a peri-splenic abscess, gastro-colonic, as well as gastro-bronchial fistulae. She required initial ICU care for pneumonia and sepsis before undergoing takedown of the gastro-bronchial fistula by thoracic surgery, followed by this case: conversion to a Roux-en-Y gastric bypass and repair of the colonic fistula. Post-operatively, she developed a controlled colonic leak managed by percutaneous drainage.
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