Nasser Sakran1,2, Roxanna Zakeri3, Brijesh Madhok4, Yitka Graham5,6, Chetan Parmar3, Kamal Mahawar5,7, Chanpreet Arhi8, Kamran Shah9, Sjaak Pouwels10. 1. Department of Surgery, Emek Medical Center, 21 Izhak Rabin Blvd, 1834111, Afula, Israel. sakranas@gmail.com. 2. Technion - Israel Institute of Technology, Haifa, Israel. sakranas@gmail.com. 3. Department of Surgery, Whittington Health NHS Trust, London, UK. 4. East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, United Kingdom. 5. Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK. 6. Facultad de Psucologia, Universidad Anahuac Mexico, Mexico City, Mexico. 7. Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK. 8. Department of Surgery, University Hospital Lewisham, London, UK. 9. Bariatric and Upper GI Department, GB Obesitas Skaane, Malmö, Sweden. 10. Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands.
Abstract
BACKGROUND: Splenic abscess is a rare complication following sleeve gastrectomy. METHODS: We performed a systematic review to clarify its clinical significance, presentation, and management. PubMed, Embase, MEDLINE, Google Scholar, and the Cochrane Library were searched up to the 19th of July 2020. A total of 18 patients were included, of which 11 were female and 7 were male. The mean age was 34.1 ± 12.3 years, and the mean body mass index was 45.8 ± 7.6 kg/m2. Type 2 diabetes mellitus was reported in 11.1% of patients and hypertension in 22.2%. Fever was the most common presenting symptom seen in 17 (94.4%) patients, followed by abdominal pain in 10 (55.6%). The mean duration from surgery to presentation was 98.6 ± 132.7 days (range 10-547 days). Computed tomography was used for investigations in 17/18 (94.4%) patients. Seven patients had reported leak, three reported bleeding, and 2 reported pleural effusion. Thirteen patients had unilocular abscess. All patients were treated with antibiotics. Four patients needed total parenteral nutrition, and three were given proton pump inhibitor. In total, 11 patients needed percutaneous drainage as a part of treatment and 11 patients needed total splenectomy and 1 needed partial splenectomy. CONCLUSION: Splenic abscess following sleeve gastrectomy is a rare identity. The etiology of formation of splenic abscess needs further studies. A computed tomography of the abdomen with contrast is the preferred diagnostic tool. There is no gold standard treatment for splenic abscess.
BACKGROUND:Splenic abscess is a rare complication following sleeve gastrectomy. METHODS: We performed a systematic review to clarify its clinical significance, presentation, and management. PubMed, Embase, MEDLINE, Google Scholar, and the Cochrane Library were searched up to the 19th of July 2020. A total of 18 patients were included, of which 11 were female and 7 were male. The mean age was 34.1 ± 12.3 years, and the mean body mass index was 45.8 ± 7.6 kg/m2. Type 2 diabetes mellitus was reported in 11.1% of patients and hypertension in 22.2%. Fever was the most common presenting symptom seen in 17 (94.4%) patients, followed by abdominal pain in 10 (55.6%). The mean duration from surgery to presentation was 98.6 ± 132.7 days (range 10-547 days). Computed tomography was used for investigations in 17/18 (94.4%) patients. Seven patients had reported leak, three reported bleeding, and 2 reported pleural effusion. Thirteen patients had unilocular abscess. All patients were treated with antibiotics. Four patients needed total parenteral nutrition, and three were given proton pump inhibitor. In total, 11 patients needed percutaneous drainage as a part of treatment and 11 patients needed total splenectomy and 1 needed partial splenectomy. CONCLUSION:Splenic abscess following sleeve gastrectomy is a rare identity. The etiology of formation of splenic abscess needs further studies. A computed tomography of the abdomen with contrast is the preferred diagnostic tool. There is no gold standard treatment for splenic abscess.
Authors: V Smyrniotis; D Kehagias; D Voros; A Fotopoulos; A Lambrou; G Kostopanagiotou; E Kostopanagiotou; J Papadimitriou Journal: Dig Surg Date: 2000 Impact factor: 2.588