Abdominal Actinomycosis: a Rare Complication after Laparoscopic Gastric Bypass

Baierlein, Sammy A.; Wistop, Anja; Looser, C.; Peters, Thomas; Riehle, Hans-Martin; Flüe, Markus von; Peterli, Ralph

doi:10.1007/s11695-007-9189-9

Cited by 19 publications

(13 citation statements)

References 17 publications

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“…For example, actinomycosis of the colon or the greater omentum is a rare differential diagnosis of colonic carcinoma or peritoneal tumor 17-19. The pathogenesis of abdominal actinomycosis is not yet well understood.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of Abdominopelvic Actinomycosis: Report of Twenty Cases and Literature Review

et al. 2009

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PurposeIntrabdominal actinomycosis is difficult to diagnose preoperatively. This chronic infection has a propensity to mimic many other diseases and may present with a wide variety of symptoms. The aim of this study was to evaluate the characteristic clinical features with review of the literature.Materials and MethodsWe retrospectively analyzed 22 patients with intrabdominal actinomycosis between January 2000 and January 2006.ResultsThere were two men and 20 women with a mean age of 42.8 years (range, 24 - 69). Twelve patients presented with masses or abdominal pain, whereas 3 patients presented with acute appendicitis. The rate of performing an emergency surgery was 50% due to symptoms of peritonitis. The mean size of tumor was 5.5 cm (range, 2.5 - 11.0). Sixty percent (n = 12) of female patients had intrauterine device (IUD). The average time to definite diagnosis was 10.6 days.ConclusionIntrabdominal abdominal actinomycosis must first be suspected in any women with a history of current or recent IUD use who presents abdominal pain. If recognized preoperatively, a limited surgical procedure, may spare the patient from an extensive operation.

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Section: Discussionmentioning

confidence: 99%

Clinical Features of Abdominopelvic Actinomycosis: Report of Twenty Cases and Literature Review

et al. 2009

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“…The value of plasma levels of these vitamins in clinically predicting relevant deficiency is not well known. In our own experience, one patient after gastric bypass complicated by a long phase of malnutrition developed typical signs of vitamin B 1 /B 6 deficiency, but plasma values always remained in the normal range [44]. To avoid complications of vitamin B 1 /B 6 deficiency, clinical suspicion may be of greater importance than plasma levels.…”

Section: Discussionmentioning

confidence: 88%

Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study

et al. 2010

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Background Deficiencies in micronutrients after bariatric operations are frequent, despite routine supplementation. Main outcome measures were pre-and postoperative frequency of nutrient deficiencies and success rate of their treatment. Between 5/2004 and 12/2006, 136 patients (m:f=0:4) with an average body mass index of 45 (35-58) kg/m 2 and age of 53 (21-66) years were prospectively analysed. Laparoscopic Roux-Y-gastric bypass (LRYGB) was performed in 86 patients and laparoscopic sleeve gastrectomy (LSG) was performed in 50 patients. The patients were examined before surgery as well as 3, 6, 12, 24, 30, and 36 months postoperatively using a standard protocol including laboratory tests. The mean follow-up time was 24.4 (12-40) months; the follow-up rate was 100%. Results Prior to surgery, 57% of the patients had at least one deficiency, 23% of whom had vitamin D 3 deficiency. Frequent postoperative deficiencies after LSG were zinc, vitamin D 3 , folic acid, iron, and vitamin B 12 ; after LRYGB, vitamin B 12 , vitamin D 3 , zinc, and secondary hyperparathyroidism. No vitamin B 1 or B 6 deficiencies were found. Calcium levels were normal in all patients. Treatment of the deficiencies was mostly successful. Conclusion Preoperatively, 57% of morbidly obese patients already had a deficiency. Postoperatively, significantly more vitamin B 12 and vitamin D deficiencies and hyperparathyroidism were found in patients who had undergone LRYGB. After LSG, folate deficiency was more frequent (but not significantly so). Calcium levels were normal in all patients; therefore, parathyroid hormone and vitamin D 3 levels are more sensitive markers for early detection of disorders of calcium metabolism. Iron deficiency anaemia is most efficiently treated by IV therapy. Methods

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“…Although complication rates are relatively low with major complications in approximately 10% of the procedures [10], more cases of unusual complications are being documented due to the exponential growth in the number of patients undergoing bariatric operations with long-term follow-up [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Brown Bowel Syndrome Secondary to Jejunoileal Bypass: The First Case Report

et al. 2009

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A 58-year-old woman with a surgical history of jejunoileal bypass in 1980 for weight reduction sought medical attention with multiple complaints. The patient had not been taking any nutritional supplements since her bypass surgery, 26 years previously. She was found to have osteomalacia, chronic diarrhea, secondary hyperparathyroidism, and hyperoxaluria with a frequent history of nephrolithiasis. Because of her severe osteodystrophy and metabolic complications, reversal of her jejunoileal bypass was recommended. Reversal of the jejunoileal bypass with a sleeve gastrectomy was performed. Laparotomy revealed brown discoloration of the entire alimentary limb with atrophy of the bypassed intestinal limb. Histologic examination of the resected small bowel demonstrated brown pigment deposits within smooth muscle cells of the bowel wall. The pigment stained positive with Fontana-Masson most likely representing lipofuscin. We report a case of brown bowel syndrome complicating jejunoileal bypass, the first case reported in the literature to the best of our knowledge.

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Abdominal Actinomycosis: a Rare Complication after Laparoscopic Gastric Bypass

Cited by 19 publications

References 17 publications

Clinical Features of Abdominopelvic Actinomycosis: Report of Twenty Cases and Literature Review

Clinical Features of Abdominopelvic Actinomycosis: Report of Twenty Cases and Literature Review

Fewer Nutrient Deficiencies After Laparoscopic Sleeve Gastrectomy (LSG) than After Laparoscopic Roux-Y-Gastric Bypass (LRYGB)—a Prospective Study

Brown Bowel Syndrome Secondary to Jejunoileal Bypass: The First Case Report

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