Gómez-Arciniega M, Domínguez-Meléndez KE, Millán-Matta CX

Language: Spanish
References: 9
Page: 511-513
PDF size: 76.41 Kb.

ABSTRACT

Objective: We report the case of a patient with a gastropleural fistula and its treatment in a second-level general hospital.
Clinical case: The patient is a 30-year-old male with a left thoraco-abdominal gun injury. We performed exploratory laparatomy, finding an injury in the anterior side of the gastric fundus, which necessitated primary closure. During the third postoperative day, we diagnosed pleural effusion. We inserted a thoracostomy tube, obtaining turbid but not fetid material. After 24 h, pleural effusion was still present, and we observed particles of food through the thoracostomy tube. We performed clearing thoracotomy and observed in the diaphragm a hole of ~3 cm in diameter with protrusion of gastric mucosa. We performed exploratory laparatomy with resection of this area and closure with a linear stapler and closure of the diaphragm hole. The patient’s postoperative evolution was favorable and, at the seventh postoperative day, the patient was discharged with good pulmonary expansion.
Conclusions: Gastropleural fistula is a rare complication that may develop with many conditions. In the case of our patient, it was secondary to a gun injury. Diagnosis was made during surgery but based on suspicious preoperative symptoms. This led to timely diagnosis and treatment, resulting in a favorable evolution for the patient.

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