Massive Gastrointestinal Bleeding Due to Splenic Artery Erosion by a PigTail Drain in a Post Sleeve Gastrectomy Leak: a Case Report

  • Elias Chahine
  • Antonio D’Alessandro
  • Mostafa Elhajjam
  • Frédéric Moryoussef
  • René-Louis Vitte
  • Robert Carlier
  • Salman Alsabah
  • Elie ChouillardEmail author
Letter to the Editor


Digestive leak remains the main complication following surgery for morbid obesity, with an incidence rate of 1 to 5%, and a potential mortality rate between 0.1 and 5% [1, 2]. Historically, the management of leaks occurring after sleeve gastrectomy (SG) involved closure devices, including endoclips, over-the-scope clips and glue, or exclusion devices like self-expandable metallic stents (SEMS) [3, 4, 5, 6]. The rate of success of these approaches averaged 70% [5, 6]. However, these commonly required several endoscopic sessions, numerous hospitalizations, and produced significant discomfort for the patients. More specifically, SEMS could lead to serious complications including migration, bleeding, ingrowth, or even perforation or stripping in up to 6% of cases [7].

More recently, the initial management of post sleeve gastrectomy leak (SGL) has shifted towards internal endoscopic drainage (IED) using either nasocavity drains and/or pigtail drains (PTD) placed throughout the...


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval Statement

For this type of study, formal consent is not required.

Informed Consent Statement

Informed consent was obtained from all individual participants included in the study.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General & Minimally Invasive SurgeryPoissy Saint Germain Medical ComplexPoissyFrance
  2. 2.Department of Interventional RadiologyAmbroise Pare HospitalBoulogne-BillancourtFrance
  3. 3.Department of Interventional EndoscopyPoissy Saint Germain Medical CenterPoissyFrance
  4. 4.Department of Digestive and Bariatric SurgeryAmiri HospitalKuwait CityKuwait
  5. 5.Department of General Surgery & Minimally Invasive SurgeryPoissy Saint-Germain Medical ComplexPoissyFrance

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