# Unusual complication following laparoscopic sleeve gastrectomy, a case report

## TL;DR

A rare case of kidney infarction after weight-loss surgery highlights the need for careful monitoring and hydration to prevent blood clots.

## Contribution

Reports a unique case of renal infarction following laparoscopic sleeve gastrectomy, emphasizing the importance of tailored anticoagulation and hydration.

## Key findings

- Renal infarction occurred post-laparoscopic sleeve gastrectomy without arterial or venous thrombi.
- Symptoms included flank pain and hematuria, with preserved renal function.
- No structural or hematologic causes were identified, suggesting surgery, obesity, and dehydration as contributing factors.

## Abstract

Venous thromboembolic events (VTE) are a rare but significant postoperative complication following bariatric surgery, with an incidence of approximately 1 %. This case report presents a 42-year-old female who developed a renal vein thrombosis leading to renal infarction following laparoscopic sleeve gastrectomy (LSG) which was a non-paradoxical embolism. To our knowledge no similar case reported in the literature.

A 42-year-old woman with obesity (BMI 35.1) and dyslipidemia underwent LSG with prophylactic anticoagulation. Three days post-op, she presented with sudden left flank pain and gross hematuria. Her laboratories were significant for elevated D-dimer and inflammatory markers. Renal function was preserved. An enhanced imaging revealed left renal infarction (60–70 % hypoperfusion) with no arterial or venous thrombi. She was treated with therapeutic anticoagulation for six months. No underlying structural or hematologic causes were found, so the infarction was likely provoked by surgery, obesity, and dehydration.

This case underscores the importance of individualized thromboembolic prophylaxis, adequate postoperative hydration, and vigilant surveillance in high-risk bariatric patients. Given the rarity of renal infarction post-LSG, further studies are warranted to guide preventative strategies and optimize patient outcomes.

This rare case of renal infarction after LSG underscores the need for quick diagnosis and team-based care to ensure the best outcome. Postoperative vigilance—hydration, personalized anticoagulation, and close follow-up—are key in reducing VTE post bariatric surgery.

•Venous thromboembolic events can occur following bariatric surgery in an unusual locations.•Renal infarction following bariatric surgery can simply present as abdominal pain.•Management of such complication should include prevention and multidisciplinary team involvement.

Venous thromboembolic events can occur following bariatric surgery in an unusual locations.

Renal infarction following bariatric surgery can simply present as abdominal pain.

Management of such complication should include prevention and multidisciplinary team involvement.