A RARE CASE REPORT OF GASTRIC LEAK: TREATED BY INNOVATIVE ENDOSCOPIC STENT-IN-STENT GASTRIC BYPASS SURGERY.

Abstract

Gastric leak is a rare clinical problem. There is a paucity of literature specific to gastric leaks. A 35 year old gentleman, who had a gunshot injury on abdomen and operated multiple times, presented with history of leakage of orally ingested contents from the dehiscent surgical wound. Imaging of abdomen revealed a large gastric defect. Esophago gastric stent was placed. Due to persistent leakage of gastric contents, another metal stent was placed within the stent, till duodenum. Subsequently, the patient could eat orally, without leakage of oral contents, and the surgical wounds healed. Eight weeks later, both stents were removed. As the patient with large gastric defect, was considered to be at high risk for reoperation, esophagoduodenal stenting was done endoscopically. This is the first case of gastric bypass by endoscopic metal stenting, with stent-in-stent technique, from esophagus to duodenum, in the normal volume stomach.