12^th Global Gastroenterologists Meeting

Introduction: Portomesenteric venous thrombosis (PMVT) is relatively rare surgical complication after laparoscopic and bariatric surgery, with difficult diagnosis and potentially severe consequences due to higher risk of bowel infarction. The purpose of this article is to present our case of PMVT after laparoscopic sleeve gastrectomy (LSG) and relative discussion of etiology, risk factors and further management.

 

Presentation & Discussion: We present the case of a 42-year-old man who underwent an uncomplicated LSG for the treatment of morbid obesity and presented on postoperative day 15 with vague diffuse abdominal pain, diagnosed with extensive PMVT involving as well the splenic vein. The patient received therapeutic anticoagulation had full hematological workup and investigations. Upon clinical and paraclinical improvement, he was discharged on day 6 of admission on proper anticoagulation. A high index of suspicion for PMVT should be considered in patients reporting diffuse vague abdominal pain after LSG owing to its lethality. Upon confirmation of PMVT, therapy should begin immediately along with extended anticoagulation therapy on discharge.

 

Conclusions: PMVT is relatively uncommon complication in patients undergoing bariatric surgery, but a high index of suspicion for definitive management should be present.