A rare complication of pyogenic hepatic abscess after laparoscopic sleeve gastrectomy—case report and literature review emphasizing the role of imaging

Elsherif, Sherif; Sharma, Sunil K.; Nguyen, Quoc-Han; Vicenty-Latorre, Fiorella; Gopireddy, Dheeraj Reddy; Kumar, Sindhu; Sharma, Smita

doi:10.1016/j.clinimag.2021.10.009

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…They speculated the liver abscess to be the migration of the bacteria from the minor leak at the staple line. Elsherif et al [ 5 ] also reported a similar case of pyogenic abscess developing 2 weeks after laparoscopic gastrectomy. Portal vein pyemia seemed to be the main pathogenesis of liver abscess in these cases.…”

Section: Discussionmentioning

confidence: 94%

Liver Abscess and Prolonged Postoperative Intra-Abdominal Free Air without Anastomotic Leakage after Laparoscopic Gastrectomy

Kataoka¹,

Oura²,

Makimoto³

2022

Case Rep Gastroenterol

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An 84-year-old thin, i.e., body mass index of 17.8, woman with gastric cancer underwent laparoscopic distal gastrectomy and lymph node dissection followed by Roux-en-Y reconstruction. During the operation, Nathanson liver retractor (NLR) was used to press the left lobe of the liver. The patient recovered uneventfully and was discharged on the 9th postoperative day. The patient, however, developed abdominal pain just on the day of discharge. Sudden onset of the abdominal pain and massive free air on computed tomography made us do diagnostic laparoscopy. Detailed laparoscopic observation showed slight liver swelling at the pressure site of the NLR, superficial band-shaped color change on the left lobe of the liver, and no anastomotic leakage, suggesting the massive free air caused by prolonged retention of postoperative intra-abdominal air. Two days later, persistent fever, inflammatory findings, and presumed liver abscess showing no healing tendency made us do ultrasound-guided aspiration to the liver focus. Bacterial culture test showed the bacterium <i>Escherichia coli</i>, being sensitive to meropenem. Despite the failure of abscess drainage, antibiotic therapy using meropenem gradually alleviated her symptoms and the patient was discharged from the hospital in 15 days after the abscess aspiration. Surgeons should note possible prolonged postoperative intra-abdominal free air and liver abscess without anastomotic leakage after laparoscopic gastrectomy especially in thin patients to avoid inappropriate postoperative management.

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Section: Discussionmentioning

confidence: 94%

Liver Abscess and Prolonged Postoperative Intra-Abdominal Free Air without Anastomotic Leakage after Laparoscopic Gastrectomy

Kataoka¹,

Oura²,

Makimoto³

2022

Case Rep Gastroenterol

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A case of multiple liver abscesses after laparoscopic sleeve gastrectomy

Khitaryan,

Mezhunts,

Melnikov

et al. 2024

Ambulatornaya khirurgiya

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Laparoscopic Sleeve Gastrectomy is the most common weight loss surgery and at the same time one of the safest. However, like any other surgery, it carries significant risks and complications. One of these complications isliver abscess. This article presents a clinical case of a 36-year-old patient who developed multiple liver abscesses one month after laparoscopic sleeve gastrectomy. The patient’s medical history, surgery details, postoperative course, symptoms and diagnostic tests are described. Liver abscess is a rare but very serious complication after sleeve gastrectomy. The etiology of this complication is still a subject of debate. We can only assume that the most likely causes ofliver abscess are intra-abdominal bleeding with hematoma formation and its subsequent infection or failure of the stapler suture line in the early postoperative period. Computed tomography with intravenous contrast is the preferred method for diagnosing this complication, especially in patients with fever, rapid heartbeat, and abdominal pain. Currently, the most effective and safe method for treating localized purulent liver diseases is percutaneous puncture and drainage of the abscess under ultrasound or CT navigation, followed by intravenous antibiotics for 4-6 weeks. This treatment strategy has proven its effectiveness in many studies. Our clinical case was no exception. The purpose of this article is to raise awareness among surgeons about this rare complication and emphasize the importance of early diagnosis and treatment.

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A rare complication of pyogenic hepatic abscess after laparoscopic sleeve gastrectomy—case report and literature review emphasizing the role of imaging

Cited by 2 publications

References 9 publications

Liver Abscess and Prolonged Postoperative Intra-Abdominal Free Air without Anastomotic Leakage after Laparoscopic Gastrectomy

Liver Abscess and Prolonged Postoperative Intra-Abdominal Free Air without Anastomotic Leakage after Laparoscopic Gastrectomy

A case of multiple liver abscesses after laparoscopic sleeve gastrectomy

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