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, 53, 367-369

A Case of Intrasplenic Displacement of an Endoscopic Double-Pigtail Stent as a Treatment for Laparoscopic Sleeve Gastrectomy Leak

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A Case of Intrasplenic Displacement of an Endoscopic Double-Pigtail Stent as a Treatment for Laparoscopic Sleeve Gastrectomy Leak

Michele Marchese et al. Int J Surg Case Rep.

Erratum in

Abstract

Introduction: The most frequent and severe complication after laparoscopic sleeve gastrectomy is gastric leak. Nowadays, there is no specific standard recommendation for its management, but the endoscopic placement of a double-pigtail drain across the leak has been proven to be effective and minimally invasive. Stent displacement into the abdominal cavity is not common and intrasplenic migration is even more rare.

Case presentation: We report a case of a 49-year-old woman with intrasplenic displacement of an endoscopic double-pigtail stent as a treatment for laparoscopic sleeve gastrectomy leak.

Discussion: Pigtail drain migration involving the spleen is rare but may potentially expose the patient to the risk of parenchymal abscess or haemorrhage. Often the clinic does not indicate early this complication.

Conclusion: We underline the need for a close radiologic follow-up, regardless of clinical conditions, in all patients treated with double-pigtail drain and its early removal in case of migration.

Keywords: Case report; Gastric leak; Internal drainage; Intrasplenic migration; Pigtail.

Figures

Fig. 1
Fig. 1
(A, B) – 8.5 Fr, 2-cm lenght double-pigtail stent was endoscopically delivered through the fistula orifice into the abdominal collection.
Fig. 2
Fig. 2
(A– D) – Abdominal computed tomographic scan with intravenous contrast, showing partial intrasplenic displacement of the double-pigtail stent, more evident in oblique projection along the axis of the vessel (red arrow in B). The presence of air in the subcapsular region confirmed intrasplenic displacement of the drain (red arrow in D).

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References

    1. Tan J.T., Kariyawasam S., Wijeratne T. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes. Surg. 2010;20(4):403–409. - PubMed
    1. Donatelli G., Ferretti S., Vergeau B.M. Endoscopic internal drainage with enteral nutrition (EDEN) for treatment of leaks following sleeve gastrectomy. Obes. Surg. 2014;24:1400–1407. - PubMed
    1. Donatelli G., Airinei G., Poupardin E. Double-pigtail stent migration invading the spleen: rare potentially fatal complication of endoscopic internal drainage for sleeve gastrectomy leak. Endoscopy. 2016;48(Suppl. 1):E74–5. UCTN. - PubMed
    1. Garofalo F., Noreau-Nguyen M., Denis R. Evolution of endoscopic treatment of sleeve gastrectomy leaks: from partially covered to long, fully covered stents. Surg. Obes. Relat. Dis. 2017;13(6):925–932. - PubMed
    1. Genser L., Pattou F., Caiazzo R. Splenic abscess with portal venous gas caused by intrasplenic migration of an endoscopic double pigtail drain as a treatment of post–sleeve gastrectomy fistula. Surg. Obes. Relat. Dis. 2016;12(1):e1–3. - PubMed
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