Acta Scientific Gastrointestinal Disorders (ISSN: 2582-1091)

Case Report Volume 3 Issue 3

Fistula-Related Pericarditis as a Complication of Gastric Bypass Surgery

Avinash Jayaswal1 and Mohamed El Koulali2

1Department of Emergency Medicine, Erasme Hospital – ULB, Brussels, Belgium
2Department of Gastroenterology, Erasme Hospital – ULB, Brussels, Belgium

*Corresponding Author: Avinash Jayaswal, Department of Emergency Medicine, Erasme Hospital – ULB, Brussels, Belgium.

Received: December 31, 2019; Published: February 17, 2020

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Abstract

Gastropericardial fistula is a life-threatening complication which results from a communication between the stomach and the pericardium. The resulting cardiac tamponnade and shock can lead to death. We present an unusual case of a 55 year-old woman who was found to have pericardial and bilateral pleural effusion on CT-scan and US imaging post-gastric bypass surgery. Endoscopy and contrast imaging showed that a fistula had developed from ischemia of the proximal eso-jejunal suture, which resulted in a para-gastric abscess communicating with pericardial and pleural spaces in the thoracic cavity. She developed ARDS and hypovolemic shock and was admitted to the ICU. Deployment of a synthetic trans-oral prosthesis endoscopically allowed tight exclusion of the fistula from the luminal cavity. A positive type Streptococcus as well as Candida albicans were respectively identified in the fluid specimen during surgical drainage. Broad spectrum antibiotics and anti-fungal agents were administered together with colchine and aspirine for pericarditis treatment. She managed to leave hospital on day 58 with a follow-up appointment 4 weeks after.

Keywords: Gastric Bypass Surgery; Pericarditis; Fistula; Endoscopic Fistula Treatment; Plastic Prosthesis; Obesity Treatment

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Citation

Citation: Avinash Jayaswal and Mohamed El Koulali. “Fistula-Related Pericarditis as a Complication of Gastric Bypass Surgery”. Acta Scientific Gastrointestinal Disorders 3.3 (2020): 01-03.



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