Band infection with splenoportal venous thrombosis: an unusual but severe complication of gastric banding.

Details

Serval ID
serval:BIB_121E023E804A
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Band infection with splenoportal venous thrombosis: an unusual but severe complication of gastric banding.
Journal
Obesity Surgery
Author(s)
Calmes J.M., Bettschart V., Raffoul W., Suter M.
ISSN
0960-8923
ISSN-L
0960-8923
Publication state
Published
Issued date
10/2002
Peer-reviewed
Oui
Volume
12
Number
5
Pages
699-702
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
BACKGROUND: Band infection after gastric banding is a relatively rare complication. In most cases, it is manifested by abdominal pain associated with fever, and/or an abscess surrounding the access port. The treatment of choice consists of band removal and antibiotic therapy, and is usually effective.
METHODS: Among the 322 patients having undergone gastric banding in our department, we report a 31-year-old woman who developed an infection of the band complicated by splenic and portal vein thrombosis 21 months after gastric banding.
RESULTS: BMI was 40.9 kg/m2 when she underwent gastric banding. Postoperative course was uneventful, and excess weight loss reached 105% after 18 months. An abdominoplasty combined with bilateral mammoplasty and thigh dermolipectomy were performed. About 3 weeks later, she developed an otitis with fever and left upper abdominal pain. Despite antibiotics, pain and fever persisted. The operative wounds showed no sign of infection, and there was no sign of peritonitis. Computerized tomography showed a left subdiaphragmatic abscess surrounding the catheter and thrombosis of the splenic and portal veins. Treatment consisted of band removal, antibiotics and heparin. Recovery was uneventful with complete resolution of the thrombosis.
CONCLUSIONS: Late band infection after gastric banding is rare, and is usually secondary to band erosion. Our case demonstrates that severe band infection can be caused by any infection causing bacteremia. Prompt band removal along with antibiotic therapy is the treatment of choice. Rapid treatment of any infection is mandatory in patients with a gastric band. Antibiotic prophylaxis during surgical and dental procedures could be useful in these patients.
Keywords
Adult, Anti-Bacterial Agents/therapeutic use, Candidiasis/diagnosis, Candidiasis/drug therapy, Female, Foreign-Body Reaction/microbiology, Gastroplasty/adverse effects, Heparin/therapeutic use, Humans, Portal Vein, Postoperative Complications/diagnosis, Postoperative Complications/drug therapy, Splenic Vein, Streptococcal Infections/blood, Streptococcal Infections/diagnosis, Venous Thrombosis/diagnosis, Venous Thrombosis/drug therapy
Pubmed
Web of science
Create date
28/01/2008 8:26
Last modification date
20/08/2019 12:39
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