Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings
<h3>Background</h3><p dir="ltr">The presentation of leak after laparoscopic sleeve gastrectomy (LSG) is variable. A missed or delayed diagnosis can lead to severe consequences. This study presents our experience: the clinical presentations, laboratory, and radiological fi...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | , |
| Published: |
2020
|
| Subjects: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1864513568142000128 |
|---|---|
| author | Mohammad Al Zoubi (14158827) |
| author2 | Nesreen Khidir (14148864) Moataz Bashah (14148867) |
| author2_role | author author |
| author_facet | Mohammad Al Zoubi (14158827) Nesreen Khidir (14148864) Moataz Bashah (14148867) |
| author_role | author |
| dc.creator.none.fl_str_mv | Mohammad Al Zoubi (14158827) Nesreen Khidir (14148864) Moataz Bashah (14148867) |
| dc.date.none.fl_str_mv | 2020-10-06T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1007/s11695-020-05008-y |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Challenges_in_the_Diagnosis_of_Leak_After_Sleeve_Gastrectomy_Clinical_Presentation_Laboratory_and_Radiological_Findings/21593907 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Diagnosis of leak post sleeve gastrectomy Post LSG leak Misdiagnosis of leak post LSG Post LSG complications |
| dc.title.none.fl_str_mv | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">The presentation of leak after laparoscopic sleeve gastrectomy (LSG) is variable. A missed or delayed diagnosis can lead to severe consequences. This study presents our experience: the clinical presentations, laboratory, and radiological findings in patients with leak after LSG.</p><h3>Methods</h3><p dir="ltr">A retrospective review of patients who were diagnosed and treated as leak after LSG at our center (January 2012–November 2019).</p><h3>Results</h3><p dir="ltr">Eighty patients developed leak: 68 (85%) after primary LSG, 6 (7.5%) after Re-LSG and 6 (7.5%) after band removal to revisional LSG. Mean age 35.9 ± 10 years. The diagnosis was within 18 ± 14 days after surgery. Five (6.3%) patients were diagnosed during the same admission. Only 29.3% of patients were diagnosed correctly from the first visit to the ER. Most were misdiagnosed as gastritis (49%) and pneumonia (22.6%). Thirty-four patients (45.3%) were diagnosed correctly at the third visit. The most common presenting symptoms were abdominal pain (90%), tachycardia (71.3%), and fever (61.3%). The mean white blood cells (WBCs) count was 14700 ± 5900 (cells/mm3), c-reactive protein (CRP) 270 ± 133 mg/L, lactic acid 1.6 ± 0.85 mmol/L, and albumin 30.3 ± 6.6 g/L. The abdominal CT scans revealed intraabdominal collection in 93.7% of patients, extravasation of contrast in 75%, and pleural effusion in 52.5%. Upper gastrointestinal contrast study (UGIC) showed extravasation of contrast in 77.5% of patients.</p><h3>Conclusion</h3><p dir="ltr">Abdominal pain, tachycardia, or fever after LSG should raise the suspicion of a leak. CT scan of the abdomen and UGIC study detected leaks in 75% and 77.5% consecutively. Only 29.3% of patients were diagnosed correctly as a leak from the first visit to the ER.</p><h2>Other Information</h2><p dir="ltr">Published in: Obesity Surgery<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1007/s11695-020-05008-y" target="_blank">http://dx.doi.org/10.1007/s11695-020-05008-y</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_f8395db96c5ecada80d50d0bdcf828fb |
| identifier_str_mv | 10.1007/s11695-020-05008-y |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/21593907 |
| publishDate | 2020 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological FindingsMohammad Al Zoubi (14158827)Nesreen Khidir (14148864)Moataz Bashah (14148867)Biomedical and clinical sciencesClinical sciencesDiagnosis of leak post sleeve gastrectomyPost LSG leakMisdiagnosis of leak post LSGPost LSG complications<h3>Background</h3><p dir="ltr">The presentation of leak after laparoscopic sleeve gastrectomy (LSG) is variable. A missed or delayed diagnosis can lead to severe consequences. This study presents our experience: the clinical presentations, laboratory, and radiological findings in patients with leak after LSG.</p><h3>Methods</h3><p dir="ltr">A retrospective review of patients who were diagnosed and treated as leak after LSG at our center (January 2012–November 2019).</p><h3>Results</h3><p dir="ltr">Eighty patients developed leak: 68 (85%) after primary LSG, 6 (7.5%) after Re-LSG and 6 (7.5%) after band removal to revisional LSG. Mean age 35.9 ± 10 years. The diagnosis was within 18 ± 14 days after surgery. Five (6.3%) patients were diagnosed during the same admission. Only 29.3% of patients were diagnosed correctly from the first visit to the ER. Most were misdiagnosed as gastritis (49%) and pneumonia (22.6%). Thirty-four patients (45.3%) were diagnosed correctly at the third visit. The most common presenting symptoms were abdominal pain (90%), tachycardia (71.3%), and fever (61.3%). The mean white blood cells (WBCs) count was 14700 ± 5900 (cells/mm3), c-reactive protein (CRP) 270 ± 133 mg/L, lactic acid 1.6 ± 0.85 mmol/L, and albumin 30.3 ± 6.6 g/L. The abdominal CT scans revealed intraabdominal collection in 93.7% of patients, extravasation of contrast in 75%, and pleural effusion in 52.5%. Upper gastrointestinal contrast study (UGIC) showed extravasation of contrast in 77.5% of patients.</p><h3>Conclusion</h3><p dir="ltr">Abdominal pain, tachycardia, or fever after LSG should raise the suspicion of a leak. CT scan of the abdomen and UGIC study detected leaks in 75% and 77.5% consecutively. Only 29.3% of patients were diagnosed correctly as a leak from the first visit to the ER.</p><h2>Other Information</h2><p dir="ltr">Published in: Obesity Surgery<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1007/s11695-020-05008-y" target="_blank">http://dx.doi.org/10.1007/s11695-020-05008-y</a></p>2020-10-06T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s11695-020-05008-yhttps://figshare.com/articles/journal_contribution/Challenges_in_the_Diagnosis_of_Leak_After_Sleeve_Gastrectomy_Clinical_Presentation_Laboratory_and_Radiological_Findings/21593907CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/215939072020-10-06T09:00:00Z |
| spellingShingle | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings Mohammad Al Zoubi (14158827) Biomedical and clinical sciences Clinical sciences Diagnosis of leak post sleeve gastrectomy Post LSG leak Misdiagnosis of leak post LSG Post LSG complications |
| status_str | publishedVersion |
| title | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings |
| title_full | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings |
| title_fullStr | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings |
| title_full_unstemmed | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings |
| title_short | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings |
| title_sort | Challenges in the Diagnosis of Leak After Sleeve Gastrectomy: Clinical Presentation, Laboratory, and Radiological Findings |
| topic | Biomedical and clinical sciences Clinical sciences Diagnosis of leak post sleeve gastrectomy Post LSG leak Misdiagnosis of leak post LSG Post LSG complications |