Year : 2007  |  Volume : 1  |  Issue : 2  |  Page : 76-78

Anesthetic considerations of gastro-bronchial fistula repair

1 Department of Anesthesia, College of Medicine, King Saud University, Saudi Arabia
2 Professor of Thoracic Surgery, King Saud University, Saudi Arabia
3 Assistant Professor, College of Medicine, King Saud University, Saudi Arabia
4 Senior Registrar Thoracic Surgery, King Khalid University Hospital, Riyadh, Saudi Arabia

Correspondence Address:
Abdelazeem El-Dawlatly
Department of Anaesthesia, P.O. Box 2925, Riyadh 11461
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

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Gastro-bronchial fistula (GBF) represents an extremely rare complication after surgical procedures. Anesthetic management of such case is challenging. We are presenting a case of GBF following gastric bypass surgery for treating morbid obesity. A 25-year-old female patient was admitted in the thoracic surgical floor with cough of gastric contents following Roux-in-Y surgery. Barium meal revealed gastro-bronchial fistulous tract. She underwent left thoracotomy under general anesthesia and the fistula was closed. Rapid sequence induction of anesthesia and proper isolation of the sound lung are important to minimize incidence of pulmonary aspiration and soiling of the non-operated lung at induction of anesthesia. All precautions of managing one lung ventilation during surgery are to be undertaken. In conclusion, anesthesia for repair of GBF is challenging. To the best of our knowledge this is the first report in literature describing the anesthetic management of surgical correction of GBF.

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