[en] Pylephlebitis, or septic thrombophlebitis of the portal vein, is an infrequent but life-threatening complication of abdominal septic events. The authors report the occurrence of pylephlebitis and multiple liver abscesses induced by a neglected intra-gastric migration of an adjustable silicone gastric band. The patient was successfully treated by broad-spectrum antibiotics and total gastrectomy with Roux-en-Y esophagojejunostomy. Postoperative recovery was marked by acute liver failure that was managed conservatively. The patient is alive and well at 1-year follow-up. This case emphasizes the interest in early removal of the band when intra-gastric migration is diagnosed.
Disciplines :
Surgery Endocrinology, metabolism & nutrition General & internal medicine
Author, co-author :
De Roover, Arnaud ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Detry, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Coimbra Marques, Carla ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Hamoir, Etienne ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Honore, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Meurisse, Michel ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
Language :
English
Title :
Pylephlebitis of the portal vein complicating intragastric migration of an adjustable gastric band
Van de Wauwer C, Irvin TT. Pylephlebitis due to perforated diverticulitis. Acta Chir Belg 2005; 105: 229-30.
Plemmons RM, Dooley DP, Longfield MS. Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era. Clin Infect Dis 1995; 21: 1114-20.
Detry O, Honoré P, Meurisse M et al. Management of fulminant hepatic failure. Acta Chir Belg 1998; 98: 235-40.
Belachew M, Belva PH, Desaive C. Long-term results of laparoscopic adjustable gastric banding for the treatment of morbid obesity. Obes Surg 2002; 12: 564-8.
Vella M, Galloway DJ. Laparoscopic adjustable gastric banding for severe obesity. Obes Surg 2003; 13: 642-8.
Chevallier J-M, Zinzindohoué F, Douard R et al. Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1,000 patients over 7 years. Obes Surg 2004; 14: 407-14.
Wylezol M, Sithkiewicz T, Gluck M et al. Intra-abdominal abscess in the course of intragastric migration of an adjustable gastric band: a potentially life-threatening complication. Obes Surg 2006; 16: 102-4.
Abu-Abeid S, Zohar DB, Sagie B et al. Treatment of intra-gastric band migration following laparoscopic banding: safety and feasibility of simultaneous laparoscopic band removal and replacement. Obes Surg 2005; 15: 849-52.
Suter M, Giusti V, Héraief E et al. Band erosion after laparoscopic adjustable gastric banding: occurrence and results after conversion to Roux-en-Y gastric bypass. Obes Surg 2004; 14: 381-6.
Duffy FJ Jr, Millan MT, Schoetz D et al. Suppurative pylephlebitis and pylethrombosis: the role of anticoagulation. Am Surg 1995; 61: 1041-4.
