Increase in hospital admissions due to complications from comestic surgeries overseas, medics say

Gordon Deegan

Irish medics have warned of increasing presentations to Irish hospitals due to complications from the rise in overseas bariatric and cosmetic tourism.

The medics have sounded their warning in a paper in the new edition of the Irish Medical Journal (IMJ) which focuses on the case of a 21-year-old woman who suffered a rare splenic fungal abscess after undergoing gastric sleeve surgery in Turkey.

The woman required hospitalisation here for "several weeks" to deal with the complication.

She presented at an emergency department here with a five-day history of abdominal pain, vomiting, and jaundice having undergone gastric sleeve surgery in Turkey three months previous.

In only the second documented case of its type recorded in medical literature, the medics detected a fungal splenic abscess following gastric sleeve surgery which required the hospitalisation of the woman for “several weeks” here as doctors treated the abscess.

The spleen is a fist-sized organ found in the upper left side of the abdomen, next to the stomach and stores and filters blood.

The medics from the Department of Surgery at both Connolly Hospital, Blanchardstown, and Beaumont Hospital in Dublin along with the Department of Radiology at Our Lady’s Hospital, Navan, state that “splenic abscess is a rare clinical entity and an even rarer complication of bariatric surgery”.

The medics record how a ultrasound detected a 4cm gas-fluid collection in the spleen and a CT of the abdomen showed a 5.2cm collection representing a small splenic abscess.

The doctors performed an ultrasound guided aspiration of the perisplenic and the paper states that following several weeks of treatment that included antibiotic therapy, “the patient was well enough to be discharged with outpatient antifungal therapy in the community”.

The paper states that “the residual abscess was monitored with outpatient Ultrasound and was shown to be reducing in size”.

The medics state that a case of splenic abscess following bariatric surgery “may be due to leak of contents from the staple line”.

They state that in the case of the 21-year-old woman, the precise reason for the abscess is unclear due to the three month delayed presentation after surgery.

They state that "this case highlights an increasingly reported trend in Irish healthcare - complications of cosmetic and bariatric tourism”.

They state that “multiple case series relating to this phenomenon on the health service have been reported in recent years and this is another example”.