Budd-Chiari syndrome following laparoscopic cholecystectomy

Area of Science:

• Hepatology
• Hematology
• Surgical Gastroenterology

Background:

• Thrombophilic disorders increase risks for splanchnic vein thrombosis during intra-abdominal surgery.
• Acute Budd-Chiari syndrome is a severe complication that can arise postoperatively.

Purpose of the Study:

• To report a case of acute Budd-Chiari syndrome in a patient with undiagnosed polycythemia vera following laparoscopic cholecystectomy.
• To emphasize the importance of presurgical evaluation for identifying myeloproliferative disorders.

Main Methods:

• Case report of a 38-year-old female patient.
• Review of presurgical biochemical tests and ultrasonography findings.
• Analysis of the patient's postoperative outcome.

Main Results:

• The patient developed acute Budd-Chiari syndrome post-laparoscopic cholecystectomy.
• Undiagnosed polycythemia vera was identified as the underlying thrombophilic condition.
• Missed indicators of myeloproliferative disorders in presurgical evaluations were noted.

Conclusions:

• Meticulous presurgical evaluation, including biochemical tests and imaging, is essential for detecting myeloproliferative disorders.
• Early diagnosis and management of conditions like polycythemia vera can prevent severe thrombotic events such as Budd-Chiari syndrome.
• Healthcare providers should maintain a high index of suspicion for thrombophilia in patients undergoing elective surgery.