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Aorto-oesophageal fistula after oesophageal stent placement in a patient with a Roux-en-Y gastric bypass

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ROYAL COLL SURGEONS ENGLAND
DOI: 10.1308/rcsann.2016.0226

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Gastric bypass; Bariatric surgery; Anastomotic leakage; Stents; Oesophageal fistula

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A 43-year-old female patient suffered from persistent anastomotic leakage after Roux-en-Y gastric bypass for morbid obesity. Endoscopic stenting of the anastomotic leakage was performed. The patient presented with haematemesis 3 weeks later. An aortooesophageal fistula was diagnosed, most likely due to ulceration of the oesophageal stent. The fistula was closed with an endovascular covered aortic stent and a new gastrojejunostomy was created. One year after surgery, the patient is in good condition. Endoscopic stents are increasingly being used to treat anastomotic leakage in bariatric patients. An aorto-oesophageal fistula is a life-threatening complication of stent placement, early clinical recognition is essential. More data are needed on the complications of anastomotic stenting in bariatric patients.

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