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drainage, gastric bypass, gastrogastric fistula, high-output fistula, pacifier, postoperative complication, Roux-en-Y, wound healing



  1. Michel, Marie RN, CWCA, CHRN, OMS
  2. Sherfey, Sally RN, CWCA


ABSTRACT: A gastrogastric fistula is a rare complication of Roux-en-Y gastric bypass resulting from communication between the gastric pouch and gastric remnant. This case report describes the creative interprofessional management of this condition arising in a 48-year-old woman. During an elective Roux-en-Y gastric bypass surgery for morbid obesity, the patient developed respiratory complications. She was admitted to the ICU, but the following day she signed herself out against medical advice, stating she was "no longer staying here." Within 24 hours, she returned to the ED for postoperative complications, and a week after the exploratory surgery, the patient developed an inoperable high-output fistula. The authors devised a creative solution to contain the effluent and achieved closure of the fistula after several weeks.