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Postoperative mesenteric venous thrombosis: Potential complication related to minimal access surgery in a patient

Iswanto Sucandy1, Jon D Gabrielsen, Anthony T Petrick

  • 1Department of Surgery, Abington Memorial Hospital, Abington, PA, USA. (Previously at Geisinger Medical Center, PA , USA.).

North American Journal of Medical Sciences
|May 5, 2012
PubMed
Abstract

Insights

Mesenteric venous thrombosis is a rare complication after laparoscopic surgery. Early diagnosis and treatment are crucial, especially in patients with hypercoagulability.

Area of Science:

  • Gastroenterology
  • Surgical Complications
  • Vascular Surgery

Background:

  • Laparoscopic surgery is a common and gold standard procedure in general surgery.
  • Mesenteric venous thrombosis is a rare but potentially fatal complication associated with laparoscopy.
  • Few case reports exist detailing this postoperative thrombotic event.

Observation:

  • A patient presented with severe abdominal pain 25 days post-laparoscopic paraesophageal hernia repair and Nissen fundoplication.
  • Exploratory laparotomy revealed extensive small bowel ischemia necessitating bowel resection and a second-look laparotomy.
  • Hematologic workup identified a genetic mutation causing hyperhomocysteinemia and hyperfibrinogenemia.

Findings:

  • The patient experienced mesenteric venous thrombosis following laparoscopic surgery.
  • Underlying hypercoagulability, including hyperhomocysteinemia and hyperfibrinogenemia, was identified.
  • This case highlights a rare complication in a patient with predisposing factors.

Implications:

  • Mesenteric venous thrombosis is a serious complication after laparoscopic procedures, particularly in hypercoagulable patients.
  • A high index of suspicion is vital for early diagnosis and effective treatment.
  • This case underscores the importance of considering thrombotic events in patients with unexplained abdominal pain post-laparoscopy.
Keywords:
Mesenteric venous thrombosishypercoagulabilitylaparoscopy

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