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Acute mesenteric venous thrombosis following laparoscopic Roux-en-Y gastric bypass
Daniel E Swartz1, Edward L Felix
1The California Institute of Minimally Invasive Surgery, Fresno, California 93710, USA. deswartzmd@aol.com
Background And Objectives:
Acute mesenteric venous thrombosis has not been previously reported as a complication following Roux-en-Y gastric bypass.
Methods:
The authors present 3 cases from a single-center experience of over 1500 patients as well as a review of the literature.
Results:
The presenting symptoms are nonspecific, and the diagnosis is often made after infarction of the intestine has occurred. A high index of clinical suspicion is required for timely diagnosis and treatment. A computed tomography scan combined with diagnostic laparoscopy are the gold standard diagnostic tests, and early anticoagulation is the optimal treatment. Diagnostic laparoscopy is essential to evaluate the degree of bowel ischemia and the need for resection.
Conclusion:
Acute mesenteric venous thrombosis following Roux-en-Y gastric bypass is a severe and potentially life-threatening complication that requires early exploration and anticoagulation.