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Portomesenteric vein thrombosis following laparoscopic greater curve plication for morbid obesity

Carol Man-Sze Lai1, Shirley Yuk-Wah Liu1, Jeffrey Ka-Tak Wong2

  • 1Department of Surgery, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.

Obesity Research & Clinical Practice
|November 11, 2018
PubMed

Insights

Portomesenteric venous thrombosis (PMVT) is a rare complication after laparoscopic bariatric surgery, especially in morbidly obese patients. Early diagnosis and treatment are crucial for survival, emphasizing the need to understand its causes and prevention strategies.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Bariatric Surgery

Background:

  • Portomesenteric venous thrombosis (PMVT) is an uncommon yet serious condition linked to intra-abdominal visceral ischemia.
  • Postoperative PMVT is rarely seen after general laparoscopic surgery but is a growing concern following laparoscopic bariatric procedures in morbidly obese individuals.
  • Accurate diagnosis of PMVT is achievable through computed tomography scans.

Observation:

  • This report details a case of PMVT in a morbidly obese female 10 days post-laparoscopic greater curve plication.
  • The patient's presentation occurred after an otherwise uneventful surgical procedure.

Findings:

  • Prompt treatment involving recanalization of the portovenous system and reversal of mesenteric venous ischemia can be life-saving.
  • Effective management of postoperative PMVT hinges on understanding its underlying etiologies and implementing preventive measures.

Implications:

  • This case highlights the importance of vigilance for PMVT in morbidly obese patients undergoing laparoscopic bariatric surgery.
  • Further research into the specific risk factors and optimal prevention strategies for PMVT in this patient population is warranted.
  • Understanding the etiology and management of PMVT is critical for improving patient outcomes and reducing mortality associated with this complication.
Keywords:
Bariatric surgeryGastroplastyMesenteric veinsPortal veinVenous thrombosis

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