Esophageal Pulmonary-splenopancreatic Fistula: A Serious Complication of Sleeve Gastrectomy

Esophagopulmonary fistulas are exceedingly rare and require surgical debridement and repair or diversion to prevent overwhelming sepsis. Fistulas that cross the diaphragm are even rarer. This report describes the case of a patient with an iatrogenic esophageal perforation after sleeve gastrectomy that was never managed definitively and in whom an esophagopulmonary-splenopancreatic fistula developed. The patient underwent an esophagectomy with esophagojejunostomy and distal pancreaticosplenectomy for management of the fistula. This case presents a rare complication of sleeve gastrectomy and highlights the need for early definitive management of esophageal perforations.