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单吻合口胃旁路术后胃胸膜瘘。一例病例报告及文献复习。

Gastropleural fistula after single anastomosis gastric bypass. A case report and review of the literature.

作者信息

Al-Shurafa Haider, Alghamdi Saleh, Albenmousa Ali, Alolayan Haifa, Al-Shurafa Zahraa

机构信息

Department of Surgery, Prince Sultan Military Medical City, Saudi Arabia.

Department of Surgery, Prince Sultan Military Medical City, Saudi Arabia.

出版信息

Int J Surg Case Rep. 2017;35:82-86. doi: 10.1016/j.ijscr.2017.03.035. Epub 2017 Apr 4.

Abstract

INTRODUCTION

Pulmonary complications after bariatric surgeries are rare but usually serious. They often occur early after surgery but the presentation might be delayed for several months. Gastropleural fistula after bariatric surgery is extremely rare and has been reported in a very small number of patients post sleeve gastrectomy and gastric bypass.

CASE PRESENTATION

A 37-year-old lady presented with left sided pleural effusion and empyema 2 years post single anastomosis gastric bypass surgery. She was found to have a large gastropleural fistula and was managed by surgical repair of the fistula with conversion to gastric bypass and decortication of the affected pleura. That resulted in significant clinical improvement and resolution of the empyema.

CONCLUSION

Gastropleural fistula is a very rare complication of bariatric surgeries and should be considered in patients who present with chronic or recurrent pulmonary infections.

摘要

引言

减肥手术后的肺部并发症很少见,但通常很严重。它们常在术后早期出现,但症状可能会延迟数月。减肥手术后的胃胸膜瘘极为罕见,仅在少数接受袖状胃切除术和胃旁路手术的患者中有过报道。

病例介绍

一名37岁女性在接受单吻合口胃旁路手术后2年出现左侧胸腔积液和脓胸。她被发现有一个大的胃胸膜瘘,通过手术修复瘘管、转为胃旁路手术以及对受影响的胸膜进行剥脱术进行治疗。这导致了显著的临床改善和脓胸的消退。

结论

胃胸膜瘘是减肥手术非常罕见的并发症,对于出现慢性或复发性肺部感染的患者应予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72b3/5412257/5d418ddfda67/gr1.jpg

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