Post sleeve gastrectomy superior mesenteric vein thrombosis. Case report

DOI 10.17605/OSF.IO/THV4X

 

Rodriguez-Gomez JA, Avalos-Trejo OA, Holguin-Estrada EA, Bernal-Velazquez H, Garcia-Trujillo U, Noreña-Rosales JA. Post sleeve gastrectomy superior mesenteric vein thrombosis. Case report. Am J Med Surg. 2020 Oct 2(1):10-13.

From the Department of Bariatric and Metabolic Surgery  at Hospital General Dr. Salvador Zubrian Anchondo. Chihuahua, Mexico. Received on October 2, 2020. Accepted on October 5, 2020. Published on October 6, 2020

Abstract: Mesenteric venous thrombosis has been recognized as a cause of intestinal necrosis for more than 100 years, the first descriptions were made by Elliot. It occurs in 5 to 15% of all mesenteric ischemia cases and usually involves the superior mesenteric vein. With the advent of the laparoscopic era in abdominal procedures, this complication, although rare, must be taken into account. Laparoscopic gastric sleeve currently represents one of the most performed procedures in bariatric surgery, and portomesenteric venous thrombosis has been reported as one of its rarest complications with high morbidity and mortality. Stasis on the portal venous system, surgical manipulation as well as damage to the splanchnic endothelium, the use of oral contraceptives, and obesity have been documented as possible etiologies. Usually the clinical manifestations appear after 14 days. Computed tomography helps to make the diagnosis and determine the extent of the pathology. A high index of suspicion is needed for its diagnosis and later to establish an adequate management which must be individualized in each patient. We report the case of a 27-year-old female patient, with a history of insulin resistance, who underwent a laparoscopic gastric sleeve that later presented with mesenteric venous thrombosis, re-admitted to the hospital at 20 days and successfully managed with anticoagulation and thrombolysis.

Keywords: Intestinal ischemia, mesenteric thrombosis, sleeve gastrectomy.