title: [Splenic late infarction after laparoscopic gastrectomy: a case report].
abstract: BACKGROUND
  Laparoscopic gastrectomy has emerged in recent years as an effective technique for the treatment of morbid obesity due to low mortality morbidity rates. Its complications include dehiscence suture line, and others such as splenic infarction. We discuss a case of splenic infarction after laparoscopic gastrectomy.
  
  
  METHODS
  45 year old male with a BMI of 37.8 kg/m2, diabetes-II for 15 years, the last five in treatment with insulin, a fasting blood glucose around 140mg/dl, HbA1c of 7.3mg/dl and microangiopathy diabetic nephropathy. The patient underwent a laparoscopic sleeve gastrectomy and he was discharged from hospital 48hours later. 1 month later he presented at the hospital for epigastric pain and fever up to 40° C. An intra abdominal abscess was detected and there was no leakage. The spleen was normal. He was treated with radiological drainage. 9 months later the patient consulted again due to epigastric pain in upper left quadrant, associated with low-grade fever. Thoraco-abdominal CT images compatible with splenic infarction. Currently patient remains asymptomatic one year after surgery.
  
  
  CONCLUSIONS
  Laparoscopic sleeve gastrectomy is one of the most popular procedures of bariatric surgery. Less common complications include abscess and the splenic infarction. Usually patients are asymptomatic, but sometimes cause fever and pain. Initial treatment should be conservative. Only in selected cases, would splenectomy be indicated.
  
  
  CONCLUSIONS
  Splenic infarction is usually an early complication, but we should keep it in mind as a long term complication for patients with persistent fever and abdominal pain after laparoscopic gastrectomy.
authors.affiliation: Servicio Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España. Electronic address: victor_soriano_@hotmail.com.
authors.forename: Víctor
authors.initials: V
authors.lastname: Soriano-Giménez
authors.affiliation: Servicio Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: David
authors.initials: D
authors.lastname: Ruiz de Angulo-Martín
authors.affiliation: Servicio Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: Vicente
authors.initials: V
authors.lastname: Munítiz-Ruiz
authors.affiliation: Servicio Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: María de Los Ángeles
authors.initials: MLÁ
authors.lastname: Ortiz-Escandell
authors.affiliation: Servicio Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: Luisa Fernanda
authors.initials: LF
authors.lastname: Martínez-de Haro
authors.affiliation: Servicio Cirugía General y Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
authors.forename: Pascual
authors.initials: P
authors.lastname: Parrilla-Paricio
mesh_terms: D000072700:Conservative Treatment; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004322:Drainage; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D013159:Splenic Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D013290:Streptococcal Infections / Q000150:complications; D014057:Tomography, X-Ray Computed
keywords: Bariatric surgery; Cirugía bariátrica; Gastrectomía vertical laparoscópica; Infarto esplénico; Laparoscopic sleeve gastrectomy; Splenic infarction