Gangrena esplénica por Streptococcus anginosus post manga gástrica laparoscópica complicada con hemoperitoneo y comunicación gastroesplénica secundaria: Caso clínico / Splenic gangrene due to Streptococcus anginosus after a sleeve gastrectomy: Report of one case

ABSTRACT

We report a 46-year-old woman, subjected to a laparoscopic sleeve gastrectomy, that had to be converted to open surgery due to the presence of adherences. She required an immediate new intervention due to a hemoperitoneum caused by a liver tear and venous bleeding from the splenic hilus. Both lesions were successfully repaired. In the postoperative period the patient had fever, leukocytosis and sialorrhea. A CAT scan showed a splenic infarction and a huge intra abdominal collection that communicated with the stomach. Streptococcus anginosus was isolated from the collection. The patient was managed with antimicrobials and percutaneous drainage with a favourable evolution and closure of the communication with the stomach.