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A rare complication of pyogenic hepatic abscess after laparoscopic sleeve gastrectomy—case report and literature review emphasizing the role of imaging

      Highlights

      • Pyogenic hepatic abscess is a rare complication after laparoscopic sleeve gastrectomy (LSG).
      • Causes of pyogenic hepatic abscess after (LSG) include hematoma or staple line leak, portal pylephlebitis or cryptogenic.
      • Contrast-enhanced CT has 95% sensitivity in the diagnosis of pyogenic hepatic abscess.
      • Imaging is essential to rule out staple line leak, assess the extent of disease and offer percutaneous drainage.

      Abstract

      A pyogenic hepatic abscess is an uncommon complication after laparoscopic sleeve gastrectomy (LSG) that can develop secondary to an infected hematoma or a staple line leak due to bacterial seeding. Appropriate screening for and management of a pyogenic hepatic abscess are essential in patients with clinical suspicion for complications after LSG. Early diagnosis is essential as pyogenic hepatic abscess can be fatal if not treated early. Only five cases have been reported in the literature so far. We present a case of pyogenic hepatic abscess that occurred two weeks after LSG in a 46-year-old female without immunosuppressive conditions or early postoperative leak. The abscess was diagnosed by computed tomography (CT) and was successfully treated with antibiotics and CT-guided drainage.

      Keywords

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