Carli Tanja, Pintar Tadeja
Abdominal Surgery, UMC Ljubljana, Ljubljana, Slovenia.
Obes Facts. 2016;9(2):138-43. doi: 10.1159/000443689. Epub 2016 Apr 19.
Laparoscopic sleeve gastrectomy (LSG) is an innovative and relatively safe surgical approach for weight reduction in morbidly obese people. Splanchnic vein thrombosis (SVT) is an extremely rare complication of LSG and, if not recognized, carries a high mortality rate. This paper highlights a potentially lethal condition of SVT after LSG.
A 37-year-old morbidly obese woman was referred to our institution for LSG. Three weeks after the intervention, she was readmitted with abdominal pain, vomiting, nausea, diarrhea, and fever with positive family anamnesis to viral disease. Abdominal X-ray as well as utrasonography were both normal, and no X-ray contrast medium leakage was observed. One week later, she was readmitted with septic condition. An abdominal computed tomography scan diagnosed lienal vein thrombosis along its whole length and partial thrombosis of the superior mesenteric vein.
SVT presents very heterogeneously, which makes it extremely challenging to diagnose and to make an appropriate treatment decision. With regard to the high prevalence of obesity and the increasing frequency of LSG, prompt diagnosis and management are crucial.
腹腔镜袖状胃切除术(LSG)是一种用于病态肥胖者减重的创新且相对安全的手术方法。内脏静脉血栓形成(SVT)是LSG极为罕见的并发症,若未被识别,死亡率很高。本文着重介绍了LSG术后一种潜在致命的SVT情况。
一名37岁的病态肥胖女性因LSG被转诊至我院。干预三周后,她因腹痛、呕吐、恶心、腹泻及发热再次入院,家族病史显示有病毒性疾病。腹部X线及超声检查均正常,未观察到X线造影剂渗漏。一周后,她因脓毒症再次入院。腹部计算机断层扫描诊断为脾静脉全长血栓形成及肠系膜上静脉部分血栓形成。
SVT表现非常多样,这使得诊断及做出恰当的治疗决策极具挑战性。鉴于肥胖的高患病率及LSG实施频率的增加,及时诊断和处理至关重要。