Acute mesenteric venous thrombosis following laparoscopic Roux-en-Y gastric bypass.
OBJECTIVE
Acute mesenteric venous thrombosis has not been previously reported as a complication following Roux-en-Y gastric bypass.


METHODS
The authors present 3 cases from a single-center experience of over 1500 patients as well as a review of the literature.


RESULTS
The presenting symptoms are nonspecific, and the diagnosis is often made after infarction of the intestine has occurred. A high index of clinical suspicion is required for timely diagnosis and treatment. A computed tomography scan combined with diagnostic laparoscopy are the gold standard diagnostic tests, and early anticoagulation is the optimal treatment. Diagnostic laparoscopy is essential to evaluate the degree of bowel ischemia and the need for resection.


CONCLUSIONS
Acute mesenteric venous thrombosis following Roux-en-Y gastric bypass is a severe and potentially life-threatening complication that requires early exploration and anticoagulation.
Swartz
Daniel E
DE
The California Institute of Minimally Invasive Surgery, Fresno, California 93710, USA. deswartzmd@aol.com
Felix
Edward L
EL
D000208:Acute Disease; D000328:Adult; D000713:Anastomosis, Roux-en-Y; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000209:etiology*; D008642:Mesenteric Veins; D008875:Middle Aged; D020246:Venous Thrombosis / Q000209:etiology*