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Review
. 2016 Apr 12:17:241-7.
doi: 10.12659/ajcr.896892.

Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy: 3 Case Reports and a Literature Review

Mohammed Muneer  1 , Husham Abdelrahman  2 , Ayman El-Menyar  3 , Ahmad Zarour  4 , Ahmed Awad  5 , Mahmood Al Dhaheri  6 , Hassan Al-Thani  2
Affiliations
Review

Portomesenteric Vein Thrombosis After Laparoscopic Sleeve Gastrectomy: 3 Case Reports and a Literature Review

Mohammed Muneer et al. Am J Case Rep. .

Abstract

Background: Porto-mesenteric venous thrombosis (PMVT) is an infrequent but severe surgical complication developing in patients who underwent laparoscopic bariatric surgery (sleeve gastrectomy). Herein, we describe the clinical presentation, management, and outcome of 3 rare cases of PMVT after laparoscopic sleeve gastrectomy (LSG), successfully treated at our center.

Case report: All patients developed PMVT post-LSG and presented with diffused abdominal pain, nausea, and vomiting. Computed tomography (CT) of the abdomen confirmed the diagnosis of portal vein thrombosis. Two patients were treated conservatively with anticoagulation and thrombolytic therapy and the third patient required operative intervention with bowel resection.

Conclusions: PMVT is a rare presentation after LSG, which requires early diagnosis and management. Conservative management through anticoagulants and thrombolytic therapy is quite effective and, if indicated, should always be considered as the primary treatment option.

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Figures

Figure 1.
Figure 1.
(A, B) Diagnosis of portal vein thrombosis confirmed by Doppler ultrasound and computerized tomography (CT) of the abdomen (Case 1).
Figure 2.
Figure 2.
(A) Coronal section showing superior mesenteric vein thrombosis (Case 2). (B) CT scan sagittal section showing portal vein thrombosis (Case 2).
Figure 3.
Figure 3.
Re-canalization of the portal vein after tissue plasminogen activator injection (Case 2).
Figure 4.
Figure 4.
(A) Coronal section for superior mesenteric vein thrombosis (SMV). (Case 3). (B) Coronal section for portal vein thrombosis (Case 3).
See this image and copyright information in PMC

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