Multiple enteroatmospheric fistulas of gastrointestinal tract after bariatric procedure. Case report

In this case we describe multiple enteroatmospheric fistulas of gastrointestinal tract of patient after bariatric procedure. Also it presents surgical tactics that had caused development of enteroatmospheric fistulas. Started from initial bariatric procedure we described all mistakes of treatment of this patient and ways of correction of happened condition. Scheme of local treatment of enteroatmospheric fistulas with usage of active drainage of intestinal juice was decribed. This patient had gastrointestinal reconstruction after 4 month after latest surgical procedure. Full condition of gastrointestinal tract had been understood in process of operation: multiple «loops» made from small intestine, gastroenteroanastomosis leakage, formed gastrotransversoanastomosis. Resection of small intestine with enterocutaneus fistulas with full reconstruction were made. Also colostomy were made, which were closed a year after last operation. Mistakes we describe in this case were analyzed taking into account world literature of bariatric surgery and management of enteroatmospheric fistulas. In the conclusion we can say that very active surgical treatment can decrease condition of patients with multiple enteroatmospheric fistulas.