title: Portomesenteric vein thrombosis after laparoscopic sleeve gastrectomy for morbid obesity.
abstract: Portomesenteric vein thrombosis (PMVT) is a rare, life-threatening pathology associated with increased prevalence in laparoscopic sleeve gastrectomy (LSG) versus other gastric bypass procedures. Gaining popularity, LSG is becoming the first choice of patients and physicians alike due to its low complication profile compared to the gastric bypass procedure. We present the case of a 34-year-old woman who underwent an uncomplicated LSG for the treatment of morbid obesity, and presented on postoperative day 13 with PMVT. The patient underwent mechanical thrombectomy and thrombolytic therapy. After 2 days, patency was restored and the patient was discharged in stable condition. A high index of suspicion for PMVT should be considered in patients reporting diffuse abdominal pain after LSG. Owing to its lethality, upon confirmation of PMVT, therapy should begin immediately along with extended anticoagulation therapy on discharge.
authors.affiliation: Department of Surgery, Mercy Catholic Medical Center, Darby, Pennsylvania, USA.
authors.forename: Leslie S
authors.initials: LS
authors.lastname: Anewenah
authors.affiliation: Department of Surgery, Mercy Catholic Medical Center, Darby, Pennsylvania, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Asif
authors.affiliation: Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Francesco
authors.affiliation: Department of Surgery, Mercy Catholic Medical Center, Darby, Pennsylvania, USA.
authors.forename: Prashanth
authors.initials: P
authors.lastname: Ramachandra
mesh_terms: D000328:Adult; D000359:Aftercare; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005743:Gastrectomy / Q000009:adverse effects*; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D064847:Multimodal Imaging; D009767:Obesity, Morbid / Q000601:surgery*; D011169:Portal Vein / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000209:etiology; D017131:Thrombectomy / Q000379:methods; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator