A rare cause of bleeding after laparoscopic sleeve gastrectomy : pseudo-aneurysm of the gastro-omental artery.
A serious complication of laparoscopic sleeve gastrectomy (LSG) is bleeding that is primarily located along the staples lines. Bleeding may be due to several causes, including hematomas, trocar sites, or visceral pseudo-aneurysms. We reported here a case of bleeding related to a pseudo-aneurysm of the gastro-omental artery. An LSG was performed on a 43-year-old woman (BMI = 46 kg/m2) without apparent surgical complications. Fifteen days later, she was admitted to the emergency department for hematemesis and symptoms of hemorrhagic shock. Abdominal computed tomography angiography revealed blood in the stomach, without a digestive leak, and active bleeding from a pseudo-aneurysm of the gastro-omental artery. An arterial embolisation was performed with the sandwich technique and angiographic guide wires and the placement of several detachable coils. The patient was discharged two days later. We demonstrated for the first time that post-LSG bleeding may involve a pseudo-aneurysm of the gastro-omental artery.
Digestive Surgical Department, CHU Timone, Marseille, France. diane.mege@ap-hm.fr
D
D
Mege
Interventional Gastroradiology and Interventional Therapy Department, CHU Timone, Marseille, France.
G
G
Louis
Digestive Surgical Department, CHU Timone, Marseille, France.
B
B
Berthet
D000328:Adult; D017541:Aneurysm, False / Q000209:etiology* / Q000628:therapy; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods; D004621:Embolization, Therapeutic; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D009852:Omentum / Q000098:blood supply*; D012421:Rupture; D013270:Stomach / Q000098:blood supply*