Portomesenteric vein thrombosis following laparoscopic sleeve gastrectomy: are underlying haematological disorders the culprit?

Description

A 51-year-old woman with a medical history of hypothyroidism and deep vein thrombosis (DVT) during pregnancy presented to the emergency department 5 days after laparoscopic sleeve gastrectomy (LSG) complaining of worsening abdominal pain and low-grade fevers. A CT scan and upper  gastrointestional series were performed with no evidence of leak or abscess, and the patient was admitted for observation.

On hospital day 2, the patient had worsening abdominal pain and an episode of emesis. An ultrasound revealed a new moderate amount of intraperitoneal-free fluid. A CT scan was repeated which revealed a segmental non-occlusive thrombus in the splenic vein (figure 1) as well as an occlusive thrombus in the superior mesenteric vein near the portosplenic confluence (figure 2).

Figure 1

(A, B) Segmental non-occlusive thrombus (blue arrow) in the splenic vein. 

Figure 2

(A, B) Occlusive...

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