Cargando…
A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report
Laparoscopic sleeve gastrectomy (LSG) has become a frequent procedure to reduce weight and morbid obesity. The procedure involves laparoscopic resection of more than 75% of the greater curvature of the stomach, resulting in early satiety and neuro-hormonal changes that collectively promote effective...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331020/ https://www.ncbi.nlm.nih.gov/pubmed/37434619 http://dx.doi.org/10.1016/j.radcr.2023.05.075 |
_version_ | 1785070173829464064 |
---|---|
author | Juniku-Shkololli, Argjira Gjikolli, Bujar Hoti, Kreshnike Dedushi Hyseni, Guri Kadrijaj, Fatbardh Lahu, Flamur Gjikolli, Dea Hyseni, Fjolla Musa, Juna |
author_facet | Juniku-Shkololli, Argjira Gjikolli, Bujar Hoti, Kreshnike Dedushi Hyseni, Guri Kadrijaj, Fatbardh Lahu, Flamur Gjikolli, Dea Hyseni, Fjolla Musa, Juna |
author_sort | Juniku-Shkololli, Argjira |
collection | PubMed |
description | Laparoscopic sleeve gastrectomy (LSG) has become a frequent procedure to reduce weight and morbid obesity. The procedure involves laparoscopic resection of more than 75% of the greater curvature of the stomach, resulting in early satiety and neuro-hormonal changes that collectively promote effective weight loss. We present a rare case of complication of superior mesenteric vein thrombosis (SMVT) and splenic vein after LSG, with consequent bowel ischemia that was treated with open laparotomy and appropriate anticoagulation therapy. A 56-year-old obese woman (BMI of 42.5 kg/m(2)), smoker for 30 years, presented to the emergency department with symptoms such as abdominal pain, fever, nausea and vomiting, 2 weeks after LSG intervention. Her white blood cell count was 15.5 (normal values: 3.8-10.4 × 10(3) /µL), while C- reactive protein level was 193 (normal values: 0.0-6.0 mg/L) and her D-Dimer level 4.69 (normal values: 0-0.50 mg/L). Abdominal CT with contrast showed a filling defect in the superior mesenteric and splenic vein, free perihepatic and Douglas pouch fluid, as well as small bowel thickening. An open laparotomy was performed and the necrotic segment of bowel of 80 cm was removed. The postoperative period went relatively well, despite the diarrhea that continued for the next 4 months after the intervention. The most common causes leading the development of this complication include: hypercoagulable state, dehydration, increased intra-abdominal pressure during the procedure and other secondary factors. The main symptom is abdominal pain, followed by nausea, vomiting, diarrhea and bleeding from the gastrointestinal tract. SMVT and SVT should be considered as a possible complication in patients with abdominal pain and increased inflammatory parameters after LSG. Early diagnosis through CT imaging and rapid anticoagulation therapy is considered to reduce further complications such as intestinal infarction and portal hypertension. |
format | Online Article Text |
id | pubmed-10331020 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-103310202023-07-11 A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report Juniku-Shkololli, Argjira Gjikolli, Bujar Hoti, Kreshnike Dedushi Hyseni, Guri Kadrijaj, Fatbardh Lahu, Flamur Gjikolli, Dea Hyseni, Fjolla Musa, Juna Radiol Case Rep Case Report Laparoscopic sleeve gastrectomy (LSG) has become a frequent procedure to reduce weight and morbid obesity. The procedure involves laparoscopic resection of more than 75% of the greater curvature of the stomach, resulting in early satiety and neuro-hormonal changes that collectively promote effective weight loss. We present a rare case of complication of superior mesenteric vein thrombosis (SMVT) and splenic vein after LSG, with consequent bowel ischemia that was treated with open laparotomy and appropriate anticoagulation therapy. A 56-year-old obese woman (BMI of 42.5 kg/m(2)), smoker for 30 years, presented to the emergency department with symptoms such as abdominal pain, fever, nausea and vomiting, 2 weeks after LSG intervention. Her white blood cell count was 15.5 (normal values: 3.8-10.4 × 10(3) /µL), while C- reactive protein level was 193 (normal values: 0.0-6.0 mg/L) and her D-Dimer level 4.69 (normal values: 0-0.50 mg/L). Abdominal CT with contrast showed a filling defect in the superior mesenteric and splenic vein, free perihepatic and Douglas pouch fluid, as well as small bowel thickening. An open laparotomy was performed and the necrotic segment of bowel of 80 cm was removed. The postoperative period went relatively well, despite the diarrhea that continued for the next 4 months after the intervention. The most common causes leading the development of this complication include: hypercoagulable state, dehydration, increased intra-abdominal pressure during the procedure and other secondary factors. The main symptom is abdominal pain, followed by nausea, vomiting, diarrhea and bleeding from the gastrointestinal tract. SMVT and SVT should be considered as a possible complication in patients with abdominal pain and increased inflammatory parameters after LSG. Early diagnosis through CT imaging and rapid anticoagulation therapy is considered to reduce further complications such as intestinal infarction and portal hypertension. Elsevier 2023-06-21 /pmc/articles/PMC10331020/ /pubmed/37434619 http://dx.doi.org/10.1016/j.radcr.2023.05.075 Text en © 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Juniku-Shkololli, Argjira Gjikolli, Bujar Hoti, Kreshnike Dedushi Hyseni, Guri Kadrijaj, Fatbardh Lahu, Flamur Gjikolli, Dea Hyseni, Fjolla Musa, Juna A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report |
title | A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report |
title_full | A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report |
title_fullStr | A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report |
title_full_unstemmed | A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report |
title_short | A rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: A case report |
title_sort | rare complication with superior mesenteric vein thrombosis after laparoscopic sleeve gastrectomy: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331020/ https://www.ncbi.nlm.nih.gov/pubmed/37434619 http://dx.doi.org/10.1016/j.radcr.2023.05.075 |
work_keys_str_mv | AT junikushkololliargjira ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT gjikollibujar ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT hotikreshnikededushi ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT hyseniguri ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT kadrijajfatbardh ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT lahuflamur ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT gjikollidea ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT hysenifjolla ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT musajuna ararecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT junikushkololliargjira rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT gjikollibujar rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT hotikreshnikededushi rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT hyseniguri rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT kadrijajfatbardh rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT lahuflamur rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT gjikollidea rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT hysenifjolla rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport AT musajuna rarecomplicationwithsuperiormesentericveinthrombosisafterlaparoscopicsleevegastrectomyacasereport |