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12 April 2016 : Case report  Qatar

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 coexistence of disease or pathology

Mohammed MuneerABDE, Husham AbdelrahmanBDE, Ayman El-MenyarDEF, Ahmad ZarourDE, Ahmed AwadBD, Mahmood Al DhaheriBD, Hassan Al-ThaniDE

DOI: 10.12659/AJCR.896892

Am J Case Rep 2016; 17:241-247

Abstract

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: Gastrectomy - adverse effects, Laparoscopy, Mesenteric Vascular Occlusion - therapy, Mesenteric Veins, Portal Vein, Postoperative Complications, Venous Thrombosis - therapy

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923