Laparoscopic Management of Hemoperitoneum Occurring As A Complication of Sleeve Gastrectomy

A laparoscopic approach was used to evaluate and manage hemoperitoneum that occurred in a 50 year-old woman who had undergone recent sleeve gastrectomy complicated by pulmonary embolism and hemoperitoneum.  This case illustrates an important complication of laparoscopic sleeve gastrectomy, the usefulness of laparoscopy for managing complications of bariatric surgery, and the challenge of laparoscopy in an peritoneum filled with a significant quantity of blood.

Authors: Donald Q Brubaker, BA – West Virginia University.  Nova Szoka, MD – West Virginia University.

Laparoscopic visualization and evacuation of hemoperitoneum
Hemoperitoneum complicating prior laparoscopic sleeve gastrectomy
Hemodynamic instability
Patient positioning: supine with footboard
CT of abdomen
Palmer’s point peritoneal cavity sleeve gastrectomy staple line
Advantages: improved operative time compared to laparotomy Disadvantages: reduced visualization of peritoneal cavity compared to laparotomy
Hemorrhage, Infection, Thromboembolism
No conflicts to report for either author.
Salim Abunnaja, MD. Lawrence Tabone, MD. Alison Wilson, MD.
Sarkhosh K, Birch DW, Sharma A, Karmali S. Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon's guide. Can J Surg. 2013;56(5):347-52. Cohen A, Almog B, Satel A, Lessing JB, Tsafrir Z, Levin I. Laparoscopy versus laparotomy in the management of ectopic pregnancy with massive hemoperitoneum. Int J Gyn & Obstet. 2013;1223:139-141.

Review Laparoscopic Management of Hemoperitoneum Occurring As A Complication of Sleeve Gastrectomy.

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