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Sleeve gastrectomy with postoperative leak

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Day 3 post sleeve gastrectomy, presenting with severe epigastric pain, fever, and tachycardia.

Patient Data

Age: 40 years
Gender: Male

Only 200 mL of oral Gastrografin was tolerated secondary to pain.

Tubular stomach with an extravasated contrast material and gas in the left upper quadrant due to a postoperative leak mostly at the gastroesophageal junction.

Case Discussion

The patient presented with severe epigastric pain, fever, and tachycardia shortly after a sleeve gastrectomy. The clinical presentation and CT features are in keeping with staple line leakage mostly at the gastro-esophageal junction. Leak after sleeve gastrectomy often occurs in the first few days postoperative due to failure of staple line complete closure.

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