# Superior mesenteric vein thrombosis as uncommon complication following laparoscopic sleeve gastrectomy: a case report and literature review

## TL;DR

A rare case of vein clotting in the abdomen following weight-loss surgery is reported, emphasizing the need for early detection and treatment.

## Contribution

This case report adds to the limited literature on portomesenteric venous thrombosis after laparoscopic sleeve gastrectomy.

## Key findings

- A 49-year-old woman developed PMVT 20 days after LSG, presenting with severe epigastric pain and gastrointestinal symptoms.
- Prothrombotic factors such as factor V Leiden mutation and low Antithrombin III levels were identified.
- Anticoagulation therapy and multidisciplinary care improved the patient's condition and prevented further complications.

## Abstract

Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure with relatively low complication rates. However, portomesenteric venous thrombosis (PMVT) is an uncommon serious complication that can occur after surgery. If not diagnosed early, this condition can lead to intestinal ischemia. We present the case of a 49-year-old woman with obesity (BMI 60.9 kg/m2), hypertension, and diabetes mellitus, who developed PMVT 20 days after undergoing LSG. She presented with severe epigastric pain, nausea, and diarrhea. Imaging revealed thrombosis in the superior mesenteric and portal veins, laboratory tests indicated multiple prothrombotic factors, including factor V Leiden mutation and reduced Antithrombin III levels. The patient was managed with anticoagulation therapy and was discharged on warfarin with close INR monitoring. This case highlights the critical importance of early detection and effective treatment of PMVT after LSG. A multidisciplinary approach, including hematology and vascular surgery consultations, is crucial to prevent complications and improve patient outcomes.