Asploro Journal of Biomedical and Clinical Case Reports

Asploro Journal of Biomedical and Clinical Case Reports

Barbi GM¹, Pará LEG¹, Lopes FAD², Okawa L³, Yamaguchi GY³, Grava S^4*
1Medicine Student, UniCesumar Medical School, Avenida Guedner, Maringá, Brazil
²Thoracic Surgeon, Hospital Paraná, Maringá, Brazil
³Gastric Surgeons, Digestive Endoscopy, Hospital Paraná, Maringá, Brazil
⁴Pneumologist, MD. Msc., Professor of Medicine, UniCesumar Medical School, Avenida Guedner, Maringá, Brazil

Corresponding Author: Sergio Grava, MD, Msc ^{ORCID iD}
Address: Pneumologist, Professor of Medicine, UniCesumar Medical School, Avenida Guedner, 1610, 87050-900, Maringá, Brazil.
Received date: 08 December 2020; Accepted date: 11 January 2021; Published date: 19 January 2021

Citation: Barbi GM, Pará LEG, Lopes FAD, Okawa L, Yamaguchi GY, Grava S. Late Gastropleural Fistula Following Bariatric Surgery: Case Report. Asp Biomed Clin Case Rep. 2021 Jan 19;4(1):30-37.

Copyright © 2021 Barbi GM, Pará LEG, Lopes FAD, Okawa L, Yamaguchi GY, Grava S. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Case Report, Gastropleural Fistula, Gastrectomy, Pneumonia, Gastric Fistula

Abstract

Although bariatric surgery procedures represent well-established methods for sustained weight loss worldwide, an important number of postoperative complications can be expected in both restrictive and mixed procedures. Gastropleural fistulas (GPF) represent an extremely rare life-threatening complication following bariatric surgery. Defined as a pathological communication between the gastric tract and the pleural cavity, the establishment of an appropriate and timely diagnosis may be quite challenging for physicians. We report on a case of a 33-year-old woman, who underwent a bariatric sleeve procedure, who presented several episodes of pneumonia in different occasions postoperatively with undiagnosed causes. Three years postoperatively the patient was hospitalized for a more detailed investigation and underwent video segmentectomy unsuccessfully. GPF was diagnosed following the observation of nutritional supplement escaping through the chest drain. The patient was initially treated with different endoscopic techniques (argon glow plasma, and endoscopic balloon dilatation) for the closure of the GPF, but despite all attempts, she eventually progressed to total gastrectomy. Bariatric surgery patients suffering from recurrent episodes of pneumonia should raise the alert for the possibility of GPF.