Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.107033
Revised: April 8, 2025
Accepted: April 28, 2025
Published online: June 27, 2025
Processing time: 77 Days and 20.8 Hours
Although laparoscopic gastrolithotomy had been widely used in clinical practice, uncommon postoperative complications still require vigilance by medical staff.
Here we report a 67-year-old man who suffered for 18 months and underwent surgery several times due to a rare and undetected complication of laparoscopic gastricolithotomy. He presented to multiple hospitals because of sustained left upper quadrant abdominal pain one month after laparoscopic gastricolithotomy due to a large gastric bezoar caused by unrestrained eating of black dates and was diagnosed with possible intercostal neuritis. Many painkillers were used to relieve his symptoms but the condition progressed. Seven months after surgery, he was hospitalized as skin ulceration occurred in the left upper abdominal wall and was subsequently diagnosed with a massive thoracoabdominal wall abscess. One year after surgery, irreversible costal destruction was demonstrated. Both lesions were finally proved to be secondary damage due to a rare chronic gastro-abdominal wall fistula related to laparoscopic gastricolithotomy and the diameter of the gastric fistula reached 2 centimeters (cm). The patient was ultimately cured but underwent multi-regional incisions and drainage of the abscess, drainage of the gastric fistula, partial gastrectomy and removal of damaged ribs, and was fo
This may be the first reported case of a chronic thoracoabdominal abscess and costal destruction caused by an undetected chronic gastro-abdominal wall fistula. We believe that this is a novel type of gastric fistula and the diagnosis and treatment were challenging.
Core Tip: We report a 67-year-old man who underwent surgery several times for a rare and undetected complication of laparoscopic gastricolithotomy. He presented to multiple hospitals because of sustained left upper quadrant abdominal pain one month after laparoscopic gastricolithotomy and was subsequently diagnosed with a massive thoracoabdominal wall abscess seven months after surgery, and irreversible costal destruction one year after surgery. Both lesions were finally confirmed to be secondary damage due to a rare chronic gastro-abdominal wall fistula related to laparoscopic gastricolithotomy and the diameter of the gastric fistula reached 2 cm.