Successful treatment of gastrobronchial fistula following laparoscopic sleeve gastrectomy: A case report and review of literature

Figure 1 Imaging at presentation. A: Chest X-ray revealed a left-sided pleural effusion; B: Computed tomography showed a hydropneumothorax; C: Esophagogastroduodenoscopy identified a fistula with purulent discharge near the staple line (arrow heads) of the sleeved stomach; D: Thoracoscopic view of a guidewire (arrow heads) passing from the fistula through the diaphragm into the pleural cavity.

Figure 2 Esophagogastroduodenoscopy images during treatment. A: Endoscopic vacuum therapy with a polyurethane sponge (arrow heads) applied to the fistula orifice; B: Marked reduction in fistula size; C: Successful closure of the fistula.

Figure 3 Treatment imaging. A: Upper gastrointestinal series revealed a left-sided gastrobronchial fistula (arrowhead); B: Chest X-ray demonstrated the proper position of the covered self-expandable metallic stent (arrowhead); C: Upper gastrointestinal series after stent removal showed no contrast leak into the pleural cavity.

Figure 4 Timeline of interventions and outcomes. VATS: Video-assisted thoracoscopic surgery; EVT: Endoscopic vacuum therapy; SEMS: Self-expandable metallic stent; GPF: Gastropleural fistula; GBF: Gastrobronchial fistula.