Imaging of a gastrobronchial fistula after gastric bypass surgery and the contrast dilemma.

Abstract

Obesity and bariatric procedures have become more common in the United States over the past 20 years. Therefore, the incidence of previously rare complications is also on the rise. One of the more ominous complications is a gastric leak with subsequent creation of a fistulous tract. A very rare subset of this complication is when the fistulous tract connects the gastric pouch to the bronchial tree. Several contrast agents can be utilized for imaging of the upper gastrointestinal tract, some of which may cause significant adverse effects if not properly tailored to the specific pathology in question. We present a case of a gastrobronchial fistula developing several years after a laparoscopic Roux-en-Y gastric bypass and discuss the ideal choice of contrast material when imaging this specific pathology.