Splenic abscess with portal venous gas caused by intrasplenic migration of an endoscopic double pigtail drain as a treatment of post–sleeve gastrectomy fistula  L. Genser, M.D., F. Pattou, M.D., R. Caiazzo, M.D., Ph.D.  Surgery for Obesity and Related Diseases  Volume 12, Issue 1, Pages e1-e3 (January 2016) DOI: 10.1016/j.soard.2015.07.017 Copyright © 2016 American Society for Bariatric Surgery Terms and Conditions

Fig. 1 Upper gastrointestinal-series with gastrografin swallow showing the opacification of the large gastric leak (1) and the stenotic segment of the gastric sleeve at the level of the incisura (2). Surgery for Obesity and Related Diseases 2016 12, e1-e3DOI: (10.1016/j.soard.2015.07.017) Copyright © 2016 American Society for Bariatric Surgery Terms and Conditions

Fig. 2 Abdominal computed tomographic scan with intravenous contrast after the last endoscopic procedure showing a satisfying double pigtail drain position across the leak orifice (white arrows). Surgery for Obesity and Related Diseases 2016 12, e1-e3DOI: (10.1016/j.soard.2015.07.017) Copyright © 2016 American Society for Bariatric Surgery Terms and Conditions

Fig. 3 Abdominal computed tomographic scan with intravenous contrast at readmission showing partial intrasplenic migration of the double pigtail drain (1); a chronic gastric fistula tract with extradigestive gas bubbles at the upper part of the staple line (2); splenic abscess with a huge volume of splenic gas adjacent to the fistula tract and segmental spleen ischemia (3); and areas of decreased attenuation in the liver periphery suggestive of hepatic portal venous gas (4). Surgery for Obesity and Related Diseases 2016 12, e1-e3DOI: (10.1016/j.soard.2015.07.017) Copyright © 2016 American Society for Bariatric Surgery Terms and Conditions