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Peri-splenic abscess post sleeve gastrectomy in a Hispanic Woman

Presenting Author

Baron Ekeledo

Presentation Type

Oral Presentation

Discipline Track

Clinical Science

Abstract Type

Case Report

Abstract

Introduction: Sleeve gastrectomy (SG) is commonly carried out in patients requiring bariatric surgery. SG is a widely tolerated subspecialty procedure worldwide. Peri-splenic abscess a rare and severe complication following a SG. This case report describes peri-splenic abscess after a SG in a Hispanic Woman.

Case Report: A 49-year-old female patient presented to the Emergency Room with acute abdominal pain, hypotension and altered mental status 1 week after a sleeve gastrectomy. Her BMI at presentation was 30.4kg/m2 and she had a right upper quadrant (UQ) JP drain containing purulent material on arrival. Her laboratory values revealed leukocytosis, hypokalemia, hyperglycemia and elevated creatinine. Imaging studies were suggestive of an esophago-gastro junction (EGJ) perforation with a leak, and right and left UQ intra-abdominal abscesses. She was commenced on antibiotics and had 2 additional left UQ drains inserted. However, her imaging abnormalities persisted including worsening of the peri splenic abscess and other associated symptoms necessitating a stent placement bridging the EGJ to antrum. She was discharged home at Day 23 with the drains and antibiotics and she remains under our close observation.

Conclusion: Peri-splenic abscess is a very rare complication of SG with only about 27 cases reported in literature. To the best of our knowledge, this is the only case reported in a Hispanic woman. Prompt recognition and appropriate management of this complication will improve morbidity and mortality as in our patient.

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Peri-splenic abscess post sleeve gastrectomy in a Hispanic Woman

Introduction: Sleeve gastrectomy (SG) is commonly carried out in patients requiring bariatric surgery. SG is a widely tolerated subspecialty procedure worldwide. Peri-splenic abscess a rare and severe complication following a SG. This case report describes peri-splenic abscess after a SG in a Hispanic Woman.

Case Report: A 49-year-old female patient presented to the Emergency Room with acute abdominal pain, hypotension and altered mental status 1 week after a sleeve gastrectomy. Her BMI at presentation was 30.4kg/m2 and she had a right upper quadrant (UQ) JP drain containing purulent material on arrival. Her laboratory values revealed leukocytosis, hypokalemia, hyperglycemia and elevated creatinine. Imaging studies were suggestive of an esophago-gastro junction (EGJ) perforation with a leak, and right and left UQ intra-abdominal abscesses. She was commenced on antibiotics and had 2 additional left UQ drains inserted. However, her imaging abnormalities persisted including worsening of the peri splenic abscess and other associated symptoms necessitating a stent placement bridging the EGJ to antrum. She was discharged home at Day 23 with the drains and antibiotics and she remains under our close observation.

Conclusion: Peri-splenic abscess is a very rare complication of SG with only about 27 cases reported in literature. To the best of our knowledge, this is the only case reported in a Hispanic woman. Prompt recognition and appropriate management of this complication will improve morbidity and mortality as in our patient.

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