Endoscopic treatment of gastrocutaneous fistula following gastric bypass for obesity.

Bariatric surgery, mainly laparoscopic Roux-en-Y gastric bypass, is widely considered to be the best operation for the treatment of morbid obesity. Leak or fistula of the gastrojejunostomy is a feared complication of this procedure. A patient who developed a gastrocutaneous fistula and was successfully managed endoscopically is reported.

An unexpected two-group migration involving a sulfonynamide to nitrile rearrangement. Mechanistic studies of a thermal N --> C tosyl rearrangement.

We report the discovery of the first double-barreled thermal rearrangement of a sulfonynamide and a methoxybenzyl to a nitrile and the first rearrangement of an SO(2) group from sulfonamide to ketoimine. The rearrangement occurs under surprisingly mild conditions (onset at 100 degrees C in the melt). [reaction: see text]