Diffuse Peritonitis Caused by Splenic Abscess After Laparoscopic Sleeve Gastrectomy: A Case Report

Abstract

A splenic abscess (SA) following sleeve gastrectomy (SG) is a rare manifestation of a gastric leak (GL). The clinical findings include fever, abdominal pain, leukocytosis, and an elevated C-reactive protein. A computed tomography scan is diagnostic and can show signs of GL, or diffuse peritonitis. Treatment can either be non-operative (including large-spectrum antibiotics and percutaneous drainage) or surgical (including splenectomy). We present the case of a 41-year-old female patient with SA, with septic shock and diffuse peritonitis, successfully treated with a splenectomy three months post-SG.

The Successful Resolution of a Large Splenic Abscess With Six Years of Follow-Up and Without Recurrence

“…Percutaneous drainage is commonly employed for intra-abdominal abscesses. It is a safe and less invasive procedure and free from complications associated with open surgery [3]. However, there have been reports of possible complications associated with percutaneous drainage, such as fistula, pneumothorax, or bowel perforation [10].…”

“…In the past, up to 60% of patients with splenic abscesses succumbed to the condition due to difficulties in symptom recognition and late diagnosis [1]. The risk factors for splenic abscess include metastatic infection, diabetes mellitus, trauma, malignancy, and congenital or acquired immunodeficiency [2,3]. It commonly arises as a consequence of infectious endocarditis, affecting approximately 5% of patients [4].…”