Splenic abscess caused by Streptococcus anginosus following laparoscopic sleeve gastrectomy: a case report of a rare complication of bariatric surgery

Abstract

Splenic abscess as a complication of laparoscopic sleeve gastrectomy (LSG) is rare. There have only been six cases in the literature. In most of these cases, the classic predisposing factors for developing splenic abscess were absent, leading to the hypothesis that transient bacteraemia caused by mucosal disruption during the surgical procedure and splenic ischaemia may play a role. These patients usually present in the late post-operative period with abdominal pain, fever and leucocytosis. The preferred treatment is intravenous antibiotics and percutaneous drainage or splenectomy. We report a case of splenic abscess caused by Streptococcus anginosus that occurred 20 days after LSG in a 45-year-old woman without immunosuppressive conditions. The patient was successfully treated with antibiotic therapy and percutaneous drainage.

Splenic Abscess after Sleeve Gastrectomy

“…Splenic abscess after LSG is a very rare condition, and the literature enumerates twelve patients who experienced this condition (Table 1) [1][2][3][4][5][6][7][8]. e mechanism of formation of splenic abscess described by the previous authors include iatrogenic splenic injury during surgery, splenic ischemia after LSG, extension from a gastric staple-line leak, and temporary immune suppression in the immediate postoperative course.…”

“…We report the case of a patient who underwent LSG, complicated three weeks after surgery by a splenic abscess. And to the best of our knowledge, there were only twelve cases reported in the literature [1][2][3][4][5][6][7][8].…”

Splenic Abscess: A Rare Complication of Sleeve Gastrectomy: A Case Report and literature Review.

“…Splenic abscess is a rare clinical entity with an incidence of 0.2-0.7% in autopsy-based studies [18], with about 600 cases have been described so far in the international literature [19]. The vast majority of the available literature consisting of case reports and series from tertiary care centers [20]. Splenic abscess as a complication of laparoscopic sleeve gastrectomy (LSG) is even rarer with only 6 cases reported in the literature (2,(20)(21)(22).…”

Endoscopic Management of Gastro-colic Fistula Following Leak from Laparoscopic Sleeve Gastrectomy

“…It is accepted as a standalone procedure, effective for achieving adequate Wight loss and resolution of comorbidities in obese patients [3,4]. Complications following LSG include hemorrhage, staple line leaks, intra-abdominal abscess, stricture formation, gastroesophageal reflux and spleen associated complications [5]. Staple line leak following LSG is the most feared complication, is usually difficult to treat and need a multimodal approach including surgical, interventional radiology and endoscopic management [6].…”