Unusual complication following laparoscopic sleeve gastrectomy, a case report

Venous thromboembolic events (VTE) are a rare but significant postoperative complication following bariatric surgery, with an incidence of approximately 1 %. This case report presents a 42-year-old female who developed a renal vein thrombosis leading to renal infarction following laparoscopic sleeve gastrectomy (LSG) which was a non-paradoxical embolism. To our knowledge no similar case reported in the literature.

A 42-year-old woman with obesity (BMI 35.1) and dyslipidemia underwent LSG with prophylactic anticoagulation. Three days post-op, she presented with sudden left flank pain and gross hematuria. Her laboratories were significant for elevated D-dimer and inflammatory markers. Renal function was preserved. An enhanced imaging revealed left renal infarction (60-70 % hypoperfusion) with no arterial or venous thrombi. She was treated with therapeutic anticoagulation for six months. No underlying structural or hematologic causes were found, so the infarction was likely provoked by surgery, obesity, and dehydration.

This case underscores the importance of individualized thromboembolic prophylaxis, adequate postoperative hydration, and vigilant surveillance in high-risk bariatric patients. Given the rarity of renal infarction post-LSG, further studies are warranted to guide preventative strategies and optimize patient outcomes.

This rare case of renal infarction after LSG underscores the need for quick diagnosis and team-based care to ensure the best outcome. Postoperative vigilance-hydration, personalized anticoagulation, and close follow-up-are key in reducing VTE post bariatric surgery.