Splenic and Concomitant Liver Abscess After Laparoscopic Sleeve Gastrectomy

Marcello Avallone, MD, Angelo Iossa, MD, Pietro Termine, MD, Gianfranco Silecchia, MD, PhD

Division of General Surgery and Bariatric Center of Excellence, Department of Medicosurgical Sciences and Biotechnology, La Sapienza University of Rome, Latina, Italy (all authors).

ABSTRACT

Introduction: Laparoscopic sleeve gastrectomy (LSG) is a safe and effective procedure for losing weight and gaining control of obesity-related comorbidities. However, it is associated with postoperative complications such as bleeding, leak, and midgastric stenosis. Splenic and hepatic abscesses have been reported as unusual and rare complications after primary LSG. We report a case of splenic and concomitant hepatic abscesses after primary LSG, successful minimally invasive management, and midterm follow-up.

Case Description: We report a complex case of splenic abscess with satellite hepatic abscess plus splenic thrombosis (0.1%) diagnosed 67 days after LSG. This unusual complication was managed by a minimally invasive approach (spleen sparing) with complete resolution after 35 days. After 18 months of follow-up, the patient showed complete resolution of the splenic and liver abscesses and progressive loss of excess weight.

Conclusion: TIn high-volume centers, rare and life-threatening complications such as splenic and hepatic abscesses may be observed. The minimally invasive approach could represent an effective option of avoiding splenectomy in selected cases.

Key Words: Splenic and hepatic abscess, Sleeve gastrectomy, Complications, Thrombosis.

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