Campos Josemberg Marins, Siqueira Luciana Teixeira de, Meira Marconi Roberto de Lemos, Ferraz Alvaro Antônio Bandeira, Ferraz Edmundo Machado, Guimarães Murilo José de Barros
Universidade Federal de Pernambuco, Recife, PE, Brasil.
J Bras Pneumol. 2007 Jul-Aug;33(4):475-9. doi: 10.1590/s1806-37132007000400018.
Gastrobronchial fistula is a rare condition as a complication following bariatric surgery. The management of this condition requires the active participation of a pulmonologist, who should be familiar with aspects of the main types of bariatric surgery. Herein, we report the cases of two patients who presented recurrent subphrenic and lung abscess secondary to fistula at the angle of His for an average of 19.5 months. After relaparotomy was unsuccessful, cure was achieved by antibiotic therapy and, more importantly, by stenostomy and endoscopic dilatation, together with the use of clips and fibrin glue in the fistula. These pulmonary complications should not be treated in isolation without a gastrointestinal evaluation since this can result in worsening of the respiratory condition, thus making anesthetic management difficult during endoscopic procedures.
胃支气管瘘是减肥手术后一种罕见的并发症。这种情况的处理需要肺科医生的积极参与,肺科医生应熟悉减肥手术主要类型的相关方面。在此,我们报告两例患者的病例,他们因His角处的瘘管继发复发性膈下和肺脓肿,平均病程为19.5个月。再次剖腹手术失败后,通过抗生素治疗,更重要的是通过狭窄造口术和内镜扩张,以及在瘘管处使用夹子和纤维蛋白胶实现了治愈。这些肺部并发症不应在没有胃肠道评估的情况下单独治疗,因为这可能导致呼吸状况恶化,从而在内镜手术期间使麻醉管理变得困难。