Open AccessPortomesenteric venous thrombosis after laparoscopic sleeve gastrectomy: A case report and a call for prevention
Author(s) -
Parveen Bhatia,
Suviraj John,
Sudhir Kalhan,
Vivek Bindal
Publication year - 2015
Publication title -
journal of minimal access surgery
Language(s) - English
Resource type - Journals
eISSN - 0972-9941
pISSN - 1998-3921
DOI - 10.4103/0972-9941.152101
Subject(s) - medicine , sleeve gastrectomy , morbidly obese , surgery , presentation (obstetrics) , venous thrombosis , anticoagulant therapy , thrombosis , general surgery , weight loss , obesity , gastric bypass
Postoperative portomesenteric venous thrombosis (PMVT) is being increasingly reported after bariatric surgery. It is variable and often a nonspecific presentation along with its potential for life-threatening and life-altering outcomes makes it imperative that it is prevented, detected early and treated optimally. We report the case of a 50-year-old morbidly obese man undergoing a laparoscopic sleeve gastrectomy who developed symptomatic PMVT two weeks postsurgery, which was successfully treated by anticoagulant therapy. We provide postulates to the etiopathological mechanism for this thrombotic entity. The growing recognition that obesity and bariatric surgery create a procoagulant state regionally and systemically provides impetus for designing the ideal protocol for PMVT prophylaxis, which could be more common than currently believed. We support the early screening for PMVT in the postbariatric surgical patient with unexplainable or intractable abdominal symptoms. The role of routine surveillance and the ideal duration of post-PMVT anticoagulation is yet to be elucidated.