Portomesenteric venous thrombosis after laparoscopic sleeve gastrectomy: A case report and a call for prevention

• Published in: Journal of minimal access surgery Vol. 11; no. 4; pp. 276 - 278
• Main Authors: Bhatia, Parveen, John, Suviraj J, Kalhan, Sudhir, Bindal, Vivek
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01-10-2015; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Anticoagulants; Bariatric surgery; Care and treatment; Case studies; Complications and side effects; Diagnosis; Health aspects; laparoscopic surgery; Laparoscopy; morbid obesity; Patient outcomes; PMVT; portomesenteric venous thrombosis; Risk factors; sleeve gastrectomy; Thrombophlebitis; Unusual Case; India; laparoscopy; morbid obesity; laparoscopic surgery; Bariatric surgery; portomesenteric venous thrombosis; sleeve gastrectomy; PMVT
• ISSN: 0972-9941; 1998-3921
• DOI: 10.4103/0972-9941.152101

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.