Complication - JSLS

Splenic Injury After Colonoscopy

SLS — Thu, 16 Jan 2020 20:50:15 +0000

Caitlin R. Loseth, MD, Arianne Johnson, PhD, Rohit Sharma, MD

Santa Barbara Cottage Hospital, Santa Barbara, California, USA (Drs Loseth, Johnson, and Sharma)

ABSTRACT

Colonoscopy is a routine procedure to screen for colorectal cancer. Splenic injury is an extremely rare but potentially fatal complication. We present a case of a 74-year-old woman on edoxaban who underwent a screening colonoscopy at a nearby outpatient surgery center. While in the recovery room, she experienced abdominal pain, hypotension, and episodes of syncope, arriving to our Emergency Department approximately 10 hours after the colonoscopy. She presented to the Emergency Department with a distended abdomen, hypotensive, and with significant abdominal pain. Abdominal computed tomography scan showed significant hemoperitoneum around the bilateral paracolic gutters, spleen, and gastric fundus. She underwent emergent midline laparotomy with evacuation of 1.5 L of hemoperitoneum with ongoing bleeding from her deseroalized spleen, suggesting traction injury from colonoscopy. In patients with abdominal pain, hypotension, and low hemoglobin postcolonoscopy, splenic injury should be considered in order to recognize early and manage appropriately.

Key Words: Abdominal pain; Splenic injury; Colonoscopy; Spleen; Anticoagulant; Complication

[gview file=”https://crsls.sls.org/wp-content/uploads/2020/01/jls104193814001.pdf”]

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Acute Presentation of Laparoscopic Gastric Band Erosion

SLS — Fri, 27 Mar 2015 15:30:30 +0000

Mohammed A. Bawahab, MD, FRCS (Canada), FASMBS

Department of Surgery, Faculty of Medicine, King Khalid, University, Abha, Saudi Arabia.

ABSTRACT

Laparoscopic adjustable gastric band (LAGB) is a well-established bariatric surgical procedure. LAGB surgery is associated long term with a significant chance for reoperation within 10 years of band placement; 2 causes of reoperation are band migration and erosion. LAGB migration is a common late complication of gastric band, with a reported incidence of as much as 11%. Herein we present a patient with LAGB erosion presenting as small bowel obstruction. In our patient, the LAGB had completely eroded into the stomach and migrated through the pylorus to the upper jejunum, resulting in a small bowel obstruction. We describe our laparoscopic approach and management of this complication, which requires a high index of suspicion.

Key Words: Obesity, Laparoscopic adjustable gastric band (LAGB), Erosion, Complication, Small bowel obstruction.

[gview file=”https://crsls.sls.org/wp-content/uploads/2015/03/jls101153269001.pdf”]

The post Acute Presentation of Laparoscopic Gastric Band Erosion first appeared on JSLS.

An Unusual Small Bowel Mass: India Ink Tattooing Mimicking Malignancy

SLS — Tue, 02 Dec 2014 15:21:00 +0000

Kunal Kochar, MD, Ajit Pai, MD, Slawomir Marecik, MD, John Park, MD, Leela Prasad, MD

Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, USA (all authors).

ABSTRACT

Introduction: India ink is routinely used for preoperative marking of colonic lesions to facilitate identification during laparoscopic colon surgery. It is a relatively inert dye with few reported adverse effects.

Case Description: We report a case of inadvertent extracolonic tattooing and intra-peritoneal spillage of India ink leading to adhesions and formation of a mass, which mimicked malignancy. The relevant literature is also reviewed.

Discussion: Although India ink is a safe dye for colonic tattooing and most of its complications are asymptomatic, it can occasionally lead to complications that might mimic malignancy and cause a diagnostic dilemma.

Key Words: India ink, Small bowel mass, Malignancy, Complication, Endoscopy.

[gview file=”https://crsls.sls.org/wp-content/uploads/2014/12/jls104143379001.pdf”]

The post An Unusual Small Bowel Mass: India Ink Tattooing Mimicking Malignancy first appeared on JSLS.

Delayed Postoperative Hemorrhage After Laparoscopic Adrenalectomy

SLS — Sat, 15 Nov 2014 02:28:27 +0000

Naohiro Sata, MD, PhD, Kazuhiro Endo, MD, Yasunaru Sakuma, MD, PhD, Alan Lefor, MD, MPH,

Yoshikazu Yasuda, MD, PhD, Ken Koyama, MD, PhD, Hideki Abe, MD, PhD,

Hideo Nagai, MD, PhD

Department of Surgery, Jichi Medical University, Yakushiji Shimotsuke Tochigi, Japan

(Drs. Sata, Endo, Sakuma, Lefor, Yasuda).

Ibaraki Prefectural Central Hospital, Koibuchi Kasama Ibaraki, Japan (Drs. Koyama, Abe, Nagai)

ABSTRACT

Introduction: The current standard surgical approach for benign adrenal disease is laparoscopic adrenalectomy. Both the transperitoneal and retroperitoneal approaches have been successfully used. We describe the unusual complication of delayed retroperitoneal hemorrhage.

Case Description: The patient is a 62-year-old man who underwent retroperitoneal laparoscopic adrenalectomy. The patient did well initially and was discharged home but presented 11 days postoperatively with abdominal pain and a large hematoma seen on computed tomography scan. An interventional radiology approach with splenic artery coil embolization was successful for management of the hemorrhage.

Discussion: Surgeons must be aware of possible severe delayed complications and the appropriate procedure for the laparoscopic approach, including usage of ultrasonic cutting instruments and delayed postoperative hemorrhage

Key Words: Laparoscopic adrenalectomy, Postoperative hemorrhage, Complication[gview file=”https://crsls.sls.org/wp-content/uploads/2014/11/13-00036.pdf”]

The post Delayed Postoperative Hemorrhage After Laparoscopic Adrenalectomy first appeared on JSLS.

Richter Hernia As a Complication of Ventriculoperitoneal Shunt Placement

SLS — Wed, 12 Nov 2014 18:16:42 +0000

Quratulain Sabih, MD, Timothy Perez, MD, MPH, FACS

Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA (all authors).

ABSTRACT

Richter hernia results from herniation of the antimesenteric wall of the bowel without compromising its lumen. Insidious onset and misleading symptoms lead to delay in diagnosis and a high mortality. We report a case of Richter hernia, after ventriculoperitoneal shunt placement which was later reduced and the defect closed laparoscopically.

Key Words: Richter hernia, Complication, Laparoscopic management.

[gview file=”https://crsls.sls.org/wp-content/uploads/2014/11/13-00129.pdf”]

The post Richter Hernia As a Complication of Ventriculoperitoneal Shunt Placement first appeared on JSLS.

Hemothorax After Laparoscopic Cholecystectomy

SLS — Wed, 12 Nov 2014 17:21:53 +0000

Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands (all authors).

ABSTRACT

A patient who underwent a laparoscopic cholecystectomy presented 6 days postoperatively with chest pain on the right side. Further examination showed a hemothorax. This is a very rare complication of laparoscopic abdominal surgery. Video-assisted thoracoscopic surgery is efficient and safe in the treatment of this complication.

Key Words: Laparascopy, Cholecystectomy, Hemothorax, Complication, Video-assisted thoracoscopic surgery.

[gview file=”https://crsls.sls.org/wp-content/uploads/2014/11/13-00049.pdf”]

The post Hemothorax After Laparoscopic Cholecystectomy first appeared on JSLS.

Laparoscopic Management of Rectus Sheath Hematomas

SLS — Wed, 12 Nov 2014 16:33:37 +0000

Dina Chamsy, MD, Deirdre Lum, MD, Suketu Mansuria, MD

Center for Minimally Invasive Gynecologic Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA (all authors).

ABSTRACT

Introduction: Rectus sheath hematomas can result from shearing of rectus muscle fibers or injury to the inferior epigastric vessels, which is the most common vascular injury to occur at the time of laparoscopic surgery.

Case Description: We describe a case of a rectus sheath hematoma that was diagnosed 5 days after operative laparoscopy. We review the clinical presentation, diagnostic criteria, and therapeutic options of managing rectus sheath hematomas, and we describe the innovative use of laparoscopy for hematoma drainage after failed conservative management.

Discussion: Rectus sheath hematomas that fail conservative management can be effectively drained laparoscopically. This minimally invasive approach provides rapid symptom relief and patient recovery.

Key Words: Hematoma, Surgical instruments, Complication, Laparoscopy.

[gview file=”https://crsls.sls.org/wp-content/uploads/2014/11/13-00011.pdf”]

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