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Laparoscopic Sleeve Gastrectomy Complicated by Portomesenteric Vein Thrombosis: a Case Series
Firas Bridges1, Jennifer Gibbs2,3, Christopher Hoehmann4
1Department of General and Bariatric Surgery, Good Samaritan Hospital Medical Center, West Islip, NY, USA.
Background:
Portomesenteric vein thrombosis (PMVT) is a rare, but potentially life-threatening, complication following laparoscopic sleeve gastrectomy (LSG).
Cases:
Here, we discuss three cases of LSG complicated by the development of PMVT post-operatively. All patients presented within the first 20 days post-operatively with complaint of non-specific abdominal pain. All patients were successfully treated with therapeutic anticoagulation during hospitalization and discharged home with long-term anticoagulation.
Discussion:
As the number of LSG performed annually continues to increase, a high index of suspicion should remain for PMVT in patients presenting with abdominal pain post-operatively. We suspect that the development of PMVT in patients undergoing LSG is secondary to manipulation of short gastric vessels, tributaries of the portal venous system, in combination with local inflammation and dehydration.
Insights
Portomesenteric vein thrombosis (PMVT) is a rare complication after laparoscopic sleeve gastrectomy (LSG). Early diagnosis and anticoagulation are key for successful treatment in these patients.
Area of Science:
- Gastroenterology
- Vascular Surgery
Background:
- Laparoscopic sleeve gastrectomy (LSG) is increasingly performed worldwide.
- Portomesenteric vein thrombosis (PMVT) is a rare but serious complication post-LSG.
Observation:
- Three cases of LSG patients developing PMVT within 20 days post-operation are presented.
- Patients reported non-specific abdominal pain as the primary symptom.
Findings:
- All three patients were successfully treated with therapeutic anticoagulation.
- Patients were discharged with long-term anticoagulation therapy.
Implications:
- A high index of suspicion for PMVT is crucial in LSG patients with post-operative abdominal pain.
- Potential causes include manipulation of short gastric vessels, inflammation, and dehydration.
- Increased vigilance and prompt management can improve outcomes for this complication.
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