Pylephlebitis and Multiple Liver Abscesses Caused by Band Erosion Following Laparoscopic Adjustable Gastric Banding

Seon Ah Cha; Kyung Hoon Kim; Jong-Min Lee; Hyun Seon Kim; Ji Hye Kim; Sung-Kyun Park; Seok-Chan Kim

Article

Korean J Obes 2014; 23(2): 131-135

Published online June 30, 2014

Pylephlebitis and Multiple Liver Abscesses Caused by Band Erosion Following Laparoscopic Adjustable Gastric Banding

Seon Ah Cha, Kyung Hoon Kim, Jong-Min Lee, Hyun Seon Kim, Ji Hye Kim, Sung-Kyun Park¹, Seok-Chan Kim^*

Author Affiliations

Divisions of Pulmonology, Department of Internal Medicine, and Department of Surgery¹, College of Medicine, The Catholic University of Korea, Seoul, Korea

Received: March 29, 2013; Reviewed : July 30, 2013; Accepted: November 18, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Abstract
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Laparoscopic adjustable gastric banding (LAGB) is a widely performed surgical procedure for the treatment of morbid obesity. Erosion of the gastric band is a rare late complication of LAGB. Among the patients with the complication, 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 band erosion of an LAGB. The patient has been treated with broad-spectrum antibiotics. This case emphasizes the interest in further evaluation before removal and the requirement for early removal of the gastric band.

Keywords: Obesity, Laparoscopic adjustable gastric banding, Pylephlebitis, Liver abscess

Figures

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Fig. 1. Chest-X ray at the time of admission.

Fig. 2. (A) Abdominal CT at the time of admission. Left subdiaphragmatic abscess, multiple liver abscess, thrombophlebitis of the hepatic portal vein and splenic vein. (B) Liver CT at 19th day of admission. Reduction in size of liver abscess, increased ascites.

Fig. 3. Endogastroduodenoscopic findings. Ulcer in the esophagogastric junction, edema of the antral mucosa.

Fig. 4. Liver biopsy. Infiltration of lymphohistiocytes and neutrophils caused by chronic inflammation in the portal area

References

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References

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