An Uncommon Adverse Event of Endoscopic Vacuum Therapy and Pigtail Stent Placement for the Treatment of Bariatric Surgery Leak

Sleeve gastrectomy-transit bipartition is an effective metabolic surgery for obesity, offering significant weight loss and comorbidity resolution. Although generally safe, complications such as fistula, bleeding, or abscess may occur. Fistula remains a major challenge, often requiring endoscopic management. Endoscopic internal drainage using double-pigtail plastic stents has emerged as a minimally invasive and effective option, although stent-related adverse events, including migration or intestinal perforation, can occur. Colonic perforation from plastic stents is extremely rare, with only 59 cases reported. This case describes a late colonic perforation successfully managed endoscopically using a metallic clip, avoiding surgical intervention and achieving complete recovery.