Sleeve Gastrectomy: You Might Lose your Liver!

Area of Science:

• Gastroenterology and Hepatology
• Vascular Surgery
• Transplantation Medicine

Background:

• Sleeve gastrectomy (SG) is a leading bariatric procedure globally.
• Portomesenteric venous thrombosis (PVT) is a recognized but serious complication following SG.
• Identifying risk factors for PVT is crucial for patient safety.

Observation:

• A patient developed PVT post-SG, complicated by refractory ascites.
• The patient had a history of acquired thrombophilia-anti-cardiolipin syndrome.
• The PVT and ascites necessitated an orthotopic liver transplantation (LT).

Findings:

• This is the first reported case of LT for PVT after SG.
• Acquired thrombophilia-anti-cardiolipin syndrome was identified as a contributing factor.
• PVT following SG can have severe, life-threatening consequences.

Implications:

• Consider systematic screening for prothrombotic conditions before bariatric surgery.
• Educate patients on the potential risks and consequences of PVT after SG.
• This case underscores the importance of vigilant post-operative monitoring for PVT.