JOURNAL ARTICLE

Conservative management of an unusual bilioduodenal fistula post laparoscopic Duodeno-Ileal Switch (SADI-S) case report

E Chelala, E Adam, A Rizk, E Makhoul
International Journal of Surgery Case Reports 2017, 34: 1-3
28324798

INTRODUCTION: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is an advanced operation for morbid obesity. To our knowledge, no internal Biliodigestive Fistula has yet been reported as specific complication in the field of metabolic and bariatric Biliopancreatic diversion.

CASE PRESENTATION: In this case report, we detail the case of a 57-year-old man who underwent a Single Anastomosis Duodeno-Ileal Switch (SADI-S) bariatric procedure for morbid obesity. Upon admission 3 weeks after the SADI-S procedure acute sepsis caused by a delayed choledoco-duodenal Fistula was diagnosed. A conservative management of this rare complication was successful.

DISCUSSION: We highlight the differential diagnosis and optional treatment in such a rare complication, and how we succeeded in its conservative management, without any need for endoscopic nor surgical intervention. A review of the literature on different types of Internal Biliodigestive Fistulae and their appropriate management are reported and briefly discussed.

CONCLUSION: The aim of this case report is to highlight the existence of such a rare complication, and its successful multidisciplinary conservative medical management.

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