Infected intra-abdominal hematoma post-laparoscopic one-anastomosis mini gastric bypass: case report and literature...

Laparoscopic one-anastomosis gastric bypass (OAGB) is a widely performed bariatric procedure with favorable outcomes; however, it carries a risk of postoperative complications. An infected intra-abdominal hematoma is a rare but potentially serious complication, often presenting with nonspecific features that can delay diagnosis.

A 29-year-old female with class II obesity (BMI 36 kg/m²) underwent elective laparoscopic OAGB. The immediate postoperative course was uneventful, and she was discharged in stable condition. Eleven days later, she presented with fever and systemic symptoms without significant abdominal findings. Laboratory investigations suggested sepsis. Imaging revealed a large perigastric collection consistent with an infected hematoma. She was successfully managed with CT-guided percutaneous drainage and antibiotics, resulting in marked clinical improvement and complete recovery at a 1-month follow-up.

This case highlights the diagnostic challenge of postoperative infected hematoma, particularly in the absence of early abdominal signs. While postoperative bleeding after OAGB is uncommon, progression to an infected hematoma is rare. Imaging plays a crucial role in diagnosis, and minimally invasive approaches, such as percutaneous drainage, provide effective management with favorable outcomes.

Infected intra-abdominal hematoma should be considered in patients presenting with unexplained sepsis following OAGB. Early imaging and timely intervention are essential for successful management and improved patient outcomes.