Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy: 3 Case Reports and a Literature Review
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis), Rare co-existance of disease or pathology
Mohammed Muneer, Husham Abdelrahman, Ayman El-Menyar, Ahmad Zarour, Ahmed Awad, Mahmood Al Dhaheri, Hassan Al-Thani
Department of Surgery, Plastic Surgery, Hamad General Hospital, Doha, Qatar
Am J Case Rep 2016; 17:241-247
Porto-mesenteric venous thrombosis (PMVT) is an infrequent but severe surgical complication developing in patients who underwent laparoscopic bariatric surgery (sleeve gastrectomy). Herein, we describe the clinical presentation, management, and outcome of 3 rare cases of PMVT after laparoscopic sleeve gastrectomy (LSG), successfully treated at our center.
CASE REPORT: All patients developed PMVT post-LSG and presented with diffused abdominal pain, nausea, and vomiting. Computed tomography (CT) of the abdomen confirmed the diagnosis of portal vein thrombosis. Two patients were treated conservatively with anticoagulation and thrombolytic therapy and the third patient required operative intervention with bowel resection.
CONCLUSIONS: PMVT is a rare presentation after LSG, which requires early diagnosis and management. Conservative management through anticoagulants and thrombolytic therapy is quite effective and, if indicated, should always be considered as the primary treatment option.
Keywords: Adult, Gastrectomy - adverse effects, Laparoscopy, Mesenteric Vascular Occlusion - therapy, Mesenteric Veins, Portal Vein, Postoperative Complications, Venous Thrombosis - therapy