In 1994 Cucchi et al.7 first published a paper identifyinggastrogastric fistulas (GGF) as a complication ofopen divided Roux-en-Y gastric bypass (RYGB).The findings showed that GGF develop regardless of theremnant division from the pouch. Some authors attributeGGF to technical failure, early postoperative leaks or evenmarginal ulcers. Furthermore, diagnosis is usually difficultand requires a high index of suspicion, mainly due to a lackof pathognomonic symptoms and signs14. As of today, thereis no consensus regarding an optimal diagnostic pathway forGGF, and management is usually patient tailored13,14.
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