Bariatric Surgery Expert Discusses Inappropriate Treatment of Spleen Perforation

This case involves a male patient was admitted to hospital in Delware for a routine gastric surgery to address persistent intestinal disease. Following the procedure, the surgeon informed the patient’s family that she had accidentally perforated the man’s spleen, and was not certain as to how to proceed. The patient was given supportive care for more than 24 hours while doctors attempted to determine a course of action. Eventually, another doctor was brought in to the hospital, and the patient then underwent a splenectomy. The patient was discharged following a lengthy hospitalization, and continues to suffer from complications related to the procedure.

Question(s) For Expert Witness

1. How often do you perform this kind of surgery?

2. What are the potential complications from this surgery?

3. When a patient's spleen is damaged during surgery what is the next step?

Expert Witness Response E-001161

I am a board certified surgeon with fellowship training in bariatric surgery. I perform these operations on a weekly basis. It is puzzling to me why this surgeon would say that he does not know how to fix splenic injuries. This is something that is taught at a very basic level. Management of splenic injury depends on the degree of injury. Most splenic injuries result in bleeding. In mild cases, the spleen is repaired with cauterization or suture. In moderate or severe cases, the spleen is removed with appropriate vaccination against encapsulated bacteria afterwards. However, not repairing the splenic injury in a timely manner can lead to severe complications such as abscess, adhesions, fistulas and chronic pain. Any surgeon should know how to take care of patients with splenic injuries, as it is part of their surgical training.