4.4 Article

Pylephlebitis of the portal vein complicating intragastric migration of an adjustable gastric band

Journal

OBESITY SURGERY
Volume 16, Issue 3, Pages 369-371

Publisher

SPRINGER
DOI: 10.1381/096089206776116363

Keywords

morbid obesity; gastroplasty; gastric banding; reoperation; band erosion; pylephlebitis; portal vein thrombosis

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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 neglected intra-gastric migration of an adjustable silicone gastric band. The patient was successfully treated by broad-spectrum antibiotics and total gastrectomy with Roux-en-Y esophagojejunostomy. Postoperative recovery was marked by acute liver failure that was managed conservatively. The patient is alive and well at 1-year follow-up. This case emphasizes the interest in early removal of the band when intra-gastric migration is diagnosed.

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