Splenic hematoma as a consequence of pneumoperitoneum

Splenic injury is a rare but serious complication of bariatric surgical procedures. Given that the need for dissection of the gastrosplenic ligament during bariatric surgical procedures, splenic injury is not unfathomable. While most subcapsular splenic hematomas may be self-limiting, continued expansion may result in splenic rupture and should, therefore, be handled with great care. With the growing rate of bariatric surgical procedures worldwide, inadvertent intra-operative splenic injury may become a more prevalent surgical complication. We report that the first documented case of subcapsular hematoma and associated gas collection following laparoscopic sleeve gastrectomy, as well as, a proposed mechanism for the radiographic findings and potential complications.