Portomesenteric venous thrombosis: an early postoperative complication after laparoscopic biliopancreatic diversion.
The number of bariatric operations, as well as the incidence of perioperative complications, has risen sharply in the past ten years. Perioperative acute portal vein thrombosis is an infrequent and potentially severe postoperative complication that has not yet been reported after biliopancreatic diversion (BPD). Three cases are presented of portal vein thrombosis that occurred following BPD treatment for morbid obesity and type 2 diabetes. The thromboses were detected by abdominal ultrasound and computed tomography with intravenous contrast. The portomesenteric venous thromboses in all three cases presented as unexpected abdominal pain several days after discharge from the hospital. The complications occurred despite adequate perioperative prophylaxis and progressed to bowel gangrene in the diabetic patients only. These cases demonstrate the occurrence of this rare type of complication, which may be observed by physicians that do not routinely treat bariatric patients. Awareness of this surgical complication will allow for early diagnosis and prompt initiation of adequate therapy.
Manuela Cesaretti, Hosam Elghadban, Nicola Scopinaro, Francesco Saverio Papadia, Department of Surgery, San Martino Hospital, University of Genoa, 16132 Genoa, Italy.
Manuela
M
Cesaretti
Manuela Cesaretti, Hosam Elghadban, Nicola Scopinaro, Francesco Saverio Papadia, Department of Surgery, San Martino Hospital, University of Genoa, 16132 Genoa, Italy.
Hosam
H
Elghadban
Manuela Cesaretti, Hosam Elghadban, Nicola Scopinaro, Francesco Saverio Papadia, Department of Surgery, San Martino Hospital, University of Genoa, 16132 Genoa, Italy.
Nicola
N
Scopinaro
Manuela Cesaretti, Hosam Elghadban, Nicola Scopinaro, Francesco Saverio Papadia, Department of Surgery, San Martino Hospital, University of Genoa, 16132 Genoa, Italy.
Francesco Saverio
FS
Papadia
D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods; D015904:Biliopancreatic Diversion / Q000009:adverse effects / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D005734:Gangrene; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008642:Mesenteric Veins; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D055815:Young Adult
D000925:Anticoagulants
Bariatric surgery; Biliopancreatic diversion; Laproscopy; Portal thrombosis