Massive upper gastrointestinal haemorrhage from splenic artery erosion secondary to gastro-gastric fistula following single-anastomosis gastric bypass.
H, E.B.M. & F, Z. (2026). Massive upper gastrointestinal haemorrhage from splenic artery erosion secondary to gastro-gastric fistula following single-anastomosis gastric bypass.. BMJ case reports. https://doi.org/10.1136/bcr-2026-272115
H EBM, F Z. Massive upper gastrointestinal haemorrhage from splenic artery erosion secondary to gastro-gastric fistula following single-anastomosis gastric bypass.. BMJ case reports. 2026; doi: 10.1136/bcr-2026-272115
H EBM, F Z. Massive upper gastrointestinal haemorrhage from splenic artery erosion secondary to gastro-gastric fistula following single-anastomosis gastric bypass.[J]. BMJ case reports. 2026. DOI: 10.1136/bcr-2026-272115.
@article{h2026,
author = {El Bashir Mustafa H and Zahedi F},
title = {Massive upper gastrointestinal haemorrhage from splenic artery erosion secondary to gastro-gastric fistula following single-anastomosis gastric bypass.},
journal = {BMJ case reports},
year = {2026},
doi = {10.1136/bcr-2026-272115},
note = {PMID: 42225316},
}
TY - JOUR AU - El Bashir Mustafa H AU - Zahedi F TI - Massive upper gastrointestinal haemorrhage from splenic artery erosion secondary to gastro-gastric fistula following single-anastomosis gastric bypass. T2 - BMJ case reports PY - 2026 DO - 10.1136/bcr-2026-272115 AN - PMID:42225316 ER -
A woman in her 40s presented with massive upper gastrointestinal bleeding a few months after undergoing a single-anastomosis gastric bypass. CT abdomen and pelvis showed a marginal ulcer with adjacent inflammatory change and suspected colo-enteric fistulation. Endoscopy identified a bleeding fistulous tract; in the context of presumed Roux-en-Y anatomy, this was interpreted as a likely gastro-colic fistula, although diagnostic certainty was limited. Angiography failed to localise active extravasation. Emergency laparotomy ultimately confirmed single-anastomosis anatomy with a gastro-gastric fistula and erosion into the splenic artery. The patient required staged damage-control surgery including resection of the gastric remnant and splenectomy, followed by delayed reconstruction 1 year later. This case highlights diagnostic challenges in altered postbariatric anatomy and the potential for catastrophic vascular complications arising from fistulating marginal ulcer disease.