Severe Bile Reflux Caused by an Uncommon Stomach Connection After Sleeve Gastrectomy is Changed to One Anastomosis Gastric Bypass

A 33-year-old patient experienced severe bile reflux after conversion from sleeve gastrectomy to one anastomosis gastric bypass.

• Postoperative complications included epigastric pain, worsening reflux symptoms, steatorrhea, and hypoproteinemia.
• Preoperative endoscopy revealed bile reflux, a suture bezoar, and ulceration at the anastomosis site.
• Intraoperative findings included a gastrogastric fistula, which was confirmed through endoscopy.
• The gastrogastric fistula, an unusual cause of bile reflux, had not been previously reported.
• After resection of the fistula and conversion to Roux-en-Y gastric bypass, the patient had an uneventful recovery.

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