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Medical Science Monitor Basic Research


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

Qatar Department of Surgery, Plastic Surgery, Hamad General Hospital, Doha, Qatar

Am J Case Rep 2016; 17:241-247

DOI: 10.12659/AJCR.896892

Available online: 2016-04-12

Published: 2016-04-12


BACKGROUND: 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