Department of Surgery, New York University Medical Center, Brooklyn, New York, USA.
Department of Surgery, Nuvance Health, Rhinebeck, New York, USA.
BMJ Case Rep. 2020 Dec 22;13(12):e236202. doi: 10.1136/bcr-2020-236202.
Portomesenteric thrombosis is an important but rarely reported complication following bariatric surgery. It has been suggested that the incidence of portal vein thrombosis is directly related to many risk factors inherent in the bariatric population as well as factors related to local and systemic effects of laparoscopic surgery. Possible aetiologies vary from systemic inherited hypercoagulable states to a direct inflammatory reaction of portosystemic vessels. Here we present a case report of a 47-year-old obese women who underwent a robotic sleeve gastrectomy with subsequent development of a main portal vein, complete right intrahepatic portal vein and splenic vein thrombosis ultimately found to have a compound mutation of the methylenetetrahydrofolate reductase C677T and A1298C alleles.
门脉肠系膜血栓形成是肥胖症手术后的一种重要但很少报道的并发症。有人认为门静脉血栓形成的发生率与肥胖人群固有的许多危险因素以及与腹腔镜手术局部和全身影响有关的因素直接相关。可能的病因从全身性遗传性高凝状态到门体血管的直接炎症反应不等。在这里，我们报告了一例 47 岁肥胖女性的病例，她接受了机器人袖状胃切除术，随后发展为主门静脉、完全性右肝内门静脉和脾静脉血栓形成，最终发现亚甲基四氢叶酸还原酶 C677T 和 A1298C 等位基因的复合突变。
