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Splenic Abscess Following Sleeve Gastrectomy: A Systematic Review of Clinical Presentation and Management Methods

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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.

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Author information

Authors and Affiliations

  1. Department of Surgery, Emek Medical Center, 21 Izhak Rabin Blvd, 1834111, Afula, Israel

    Nasser Sakran

  2. Technion – Israel Institute of Technology, Haifa, Israel

    Nasser Sakran

  3. Department of Surgery, Whittington Health NHS Trust, London, UK

    Roxanna Zakeri & Chetan Parmar

  4. East Midlands Bariatric and Metabolic Institute, University Hospital of Derby and Burton NHS Foundation Trust, Derby, United Kingdom

    Brijesh Madhok

  5. Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK

    Yitka Graham & Kamal Mahawar

  6. Facultad de Psucologia, Universidad Anahuac Mexico, Mexico City, Mexico

    Yitka Graham

  7. Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK

    Kamal Mahawar

  8. Department of Surgery, University Hospital Lewisham, London, UK

    Chanpreet Arhi

  9. Bariatric and Upper GI Department, GB Obesitas Skaane, Malmö, Sweden

    Kamran Shah

  10. Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, the Netherlands

    Sjaak Pouwels

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  1. Nasser Sakran
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on behalf of the Global Bariatric Research Collaborative

Contributions

Initial idea: NS, SP

Literature search: NS, CP, SP

Data analysis: NS, RZ, BM, YG, CP, KM, CA, KS, NFG, SP

Writing the manuscript: NS, RZ, BM, YG, CP, KM, CA, KS, NFG, SP

Final approval: NS, RZ, BM, YG, CP, KM, CA, KS, NFG, SP

Corresponding author

Correspondence to Nasser Sakran.

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Sakran, N., Zakeri, R., Madhok, B. et al. Splenic Abscess Following Sleeve Gastrectomy: A Systematic Review of Clinical Presentation and Management Methods. OBES SURG 31, 2753–2761 (2021). https://doi.org/10.1007/s11695-021-05396-9

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