title: Superior mesenteric and portal vein thrombosis following laparoscopic nissen fundoplication.
abstract: This case report describes superior mesenteric and portal vein thrombosis after laparoscopic Nissen fundoplication. As a thromboembolic prophylaxis, 2,500 IU of dalteparin was given preoperatively. After postoperative day 19, the patient experienced gradually increasing abdominal pain, mostly related to meals. Physical examination and laboratory tests were normal. CT scan revealed a portal and superior mesenteric vein thrombosis. Dalteparin and warfarin treatment was started, and symptoms relieved rapidly. In a control Doppler ultrasound 1 month after the onset of the treatment, a good flow in the portal and superior mesenteric vein was seen. Possible mechanisms are discussed.
authors.affiliation: Second Department of Surgery, Helsinki University Central Hospital, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Kemppainen
authors.forename: A
authors.initials: A
authors.lastname: Kokkola
authors.forename: J
authors.initials: J
authors.lastname: Sirén
authors.forename: T
authors.initials: T
authors.lastname: Kiviluoto
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000925:Anticoagulants / Q000627:therapeutic use; D017985:Dalteparin / Q000627:therapeutic use; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008642:Mesenteric Veins; D008875:Middle Aged; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000925:Anticoagulants; D017985:Dalteparin