Unusual complication of multiple splenic abscesses arising from a feeding jejunostomy tube subsequent to total gastrectomy: A case report and literature review

An,Shuchang; Li,Bing; Cui,Rong; Yan,Feng; Yang,Guoshan; Zhao,Li; Zhang,Zhenya; Wang,Ruiqin

doi:10.3892/ol.2015.3007

Unusual complication of multiple splenic abscesses arising from a feeding jejunostomy tube subsequent to total gastrectomy: A case report and literature review

Authors:
- Shuchang An
- Bing Li
- Rong Cui
- Feng Yan
- Guoshan Yang
- Li Zhao
- Zhenya Zhang
- Ruiqin Wang
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Affiliations: Department of Respiratory Medicine, First Hospital of Tsinghua University, Beijing 100016, P.R. China, Department of General Surgery, First Hospital of Tsinghua University, Beijing 100016, P.R. China
Published online on: March 3, 2015 https://doi.org/10.3892/ol.2015.3007
Pages: 2398-2400

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Abstract

Splenic abscess is a rare clinical entity. The present study reports a case of a patient that suffered from splenic abscess secondary to septicemia resulting from Klebsiella pneumoniae infection following the removal of the feeding jejunostomy tube that was utilized subsequent to the patient undergoing total gastrectomy as part of the treatment regimen for gastric adenocarcinoma. The early clinical presentation was nonspecific and multiple splenic abscesses were subsequently identified. To reduce the risks of an additional surgical procedure in this particular patient, laparoscopic assisted splenotomy and catheter drainage were performed. Due to the severe complications that occurred in the present patient, no adjuvant chemotherapy was administered. Therefore, the unusual complication of splenic abscess subsequent to total gastrectomy should be noted, and the routine feeding jejunostomy tube placement at the time of total gastrectomy should be discussed and re‑assessed.

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1	Gil-Rendo A, Hernandez-Lizoain JL, Martinez-Regueira F, et al: Risk factors related to operative morbidity in patients undergoing gastrectomy for gastric cancer. Clin Transl Oncol. 8:354–361. 2006. View Article : Google Scholar : PubMed/NCBI
2	Songun I, Putter H, Kranenbarg EM, Sasako M and van de Velde CJ: Surgical treatment of gastric cancer: 15–year follow-up results of the randomized nationwide Dutch D1D2 trial. Lancet Oncol. 11:439–449. 2010. View Article : Google Scholar : PubMed/NCBI
3	No authors listed: Perioperative total parenteral nutrition in surgical patients. The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. N Engl J Med. 325:525–532. 1991.PubMed/NCBI
4	Chin KF, Townsend S, Wong W and Miller GV: A prospective cohort study of feeding needle catheter jejunostomy in an upper gastrointestinal surgical unit. Clin Nutr. 23:691–696. 2004. View Article : Google Scholar : PubMed/NCBI
5	Llaguna OH, Kim HJ, Deal AM, Calvo BF, Stitzenberg KB and Meyers MO: Utilization and morbidity associated with placement of a feeding jejunostomy at the time of gastroesophageal resection. J Gastrointest Surg. 15:1663–1669. 2011. View Article : Google Scholar : PubMed/NCBI
6	Srinathan SK, Hamin T, Walter S, Tan AL, Unruh HW and Guyatt G: Jejunostomy tube feeding in patients undergoing esophagectomy. Can J Surg. 56:409–414. 2013. View Article : Google Scholar : PubMed/NCBI
7	Patel SH, Kooby DA, Staley CA III and Maithel SK: An assessment of feeding jejunostomy tube placement at the time of resection for gastric adenocarcinoma. J Surg Oncol. 107:728–734. 2013. View Article : Google Scholar : PubMed/NCBI
8	Sarr MG and Zuidema GD: Splenic abscess – presentation, diagnosis, and treatment. Surgery. 92:480–485. 1982.PubMed/NCBI
9	Tung CC, Chen FC and Lo CJ: Splenic abscess: an easily overlooked disease? Am Surg. 72:322–325. 2006.PubMed/NCBI
10	Llenas-Garcia J, Fernandez-Ruiz M, Caurcel L, Enguita-Valls A, Vila-Santos J and Guerra-Vales JM: Splenic abscess: a review of 22 cases in a single institution. Eur J Intern Med. 20:537–539. 2009. View Article : Google Scholar : PubMed/NCBI
11	Song FL, Lu LX, Li CX, Yu XZ and Li Y: A retrospective analysis of 19 splenic abscess patients. Zhonghua Nei Ke Za Zhi. 52:313–317. 2013.(In Chinese). PubMed/NCBI
12	Nelken N, Ignatius J, Skinner M and Christensen N: Changing clinical spectrum of splenic abscess. A multicenter study and review of the literature. Am J Surg. 154:27–34. 1987. View Article : Google Scholar : PubMed/NCBI
13	Green BT: Splenic abscess: report of six cases and review of the literature. Am Surg. 67:80–85. 2001.PubMed/NCBI
14	Ooi LL and Leong SS: Splenic abscesses from 1987 to 1995. Am J Surg. 174:87–93. 1997. View Article : Google Scholar : PubMed/NCBI
15	Martinez DG, Sanchez AW and Garcia AP: Splenic abscess after laparoscopic Nissen fundoplication: a consequence of short gastric vessel division. Surg Laparosc Endosc Percutan Tech. 18:82–85. 2008. View Article : Google Scholar : PubMed/NCBI
16	Stamou KM, Menenakos E, Gomatos IP, Panousopoulos SG, Smparounis S, Leandros E and Zografos G: Clinical implications of sleeve gastrectomy as a source of spleen infarction or ischemia. Obes Surg. 21:1490–1493. 2011. View Article : Google Scholar : PubMed/NCBI
17	Chang CJ, Su CW and Hou MC: Abdominal pain after endoscopic hemostasis of gastric tumor bleeding. Splenic infarction with abscess formation. Gastroenterology. 137:e7–e8. 2009. View Article : Google Scholar : PubMed/NCBI
18	Lee WS, Choi ST and Kim KK: Splenic abscess: a single institution study and review of the literature. Yonsei Med J. 52:288–292. 2011. View Article : Google Scholar : PubMed/NCBI
19	Chang KC, Chuah SK, Changchien CS, et al: Clinical characteristics and prognostic factors of splenic abscess: a review of 67 cases in a single medical center of Taiwan. World J Gastroenterol. 12:460–464. 2006.PubMed/NCBI
20	Feldman LS: Laparoscopic splenectomy: standardized approach. World J Surg. 35:1487–1495. 2011. View Article : Google Scholar : PubMed/NCBI