Gastro-gastric fistula following gastric bypass: a case report

A gastro-gastric fistula is an abnormal communication between the excluded gastric pouch and the gastric remnant following Roux-en-Y gastric bypass surgery. This complication typically arises in the late postoperative period and occurs in fewer than 1% of patients. Diagnosing a gastro-gastric fistul...

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Detalles Bibliográficos
Autores: Arango Molano, Lázaro Antonio, Sánchez Gil, Andrés, Solarte Pineda, Herney, Estrada Torres, Adhara Marina
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:Perú
Institución:Sociedad de Gastroenterología del Perú
Repositorio:Revista de Gastroenterología del Perú
Idioma:español
OAI Identifier:oai:ojs.revistagastroperu.com:article/1971
Acceso en línea:https://revistagastroperu.com/index.php/rgp/article/view/1971
Access Level:acceso abierto
Palabra clave:Fístula Gástrica
Reflujo Gastroesofágico
Endoscopia Gastrointestinal
Gastric Fistula, Gastroesophageal Reflux
Endoscopy, Gastrointestinal
Descripción
Sumario:A gastro-gastric fistula is an abnormal communication between the excluded gastric pouch and the gastric remnant following Roux-en-Y gastric bypass surgery. This complication typically arises in the late postoperative period and occurs in fewer than 1% of patients. Diagnosing a gastro-gastric fistula can be clinically challenging, as it may present with a spectrum ranging from asymptomatic states to nonspecific symptoms such as epigastric pain, weight regain, gastroesophageal reflux, and emesis. A combination of endoscopic evaluation and contrast imaging studies is essential to establish a diagnosis. There is currently no optimal standardized treatment strategy. Conservative management is generally reserved for asymptomatic patients. Surgical correction remains the standard approach; however, it is technically demanding and associated with higher morbidity compared to primary bariatric procedures. Consequently, novel endoscopic techniques and approaches have emerged, demonstrating promising outcomes and safety profiles in the management of gastro-gastric fistulas.