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单吻合口胃旁路术后门静脉肠系膜血栓形成:病例报告

Presentation of portomesenteric thrombosis after one-anastomosis gastric bypass: Case report.

作者信息

Moosavi Delaram, Taherzadeh Mahsa, Mokhber Somayeh, Riazi Sajedeh, Pazouki Abdolreza

机构信息

Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Rasoule-Akram Hospital, Mansouri st., Niyayesh Ave., Sattarkhan St., Tehran, Iran.

Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Rasoule-Akram Hospital, Mansouri st., Niyayesh Ave., Sattarkhan St., Tehran, Iran.

出版信息

Int J Surg Case Rep. 2023 Oct;111:108900. doi: 10.1016/j.ijscr.2023.108900. Epub 2023 Oct 9.

Abstract

INTRODUCTION

Obesity is a serious situation that leads to non-communicable diseases like diabetes, hypertension, and others. The prevalence of obesity is growing very fast worldwide, so follow the results bariatric surgery, the most effective treatment of obesity, is increasing. Portomesentric vein thrombosis (PMVT) is one of the rare, fatal post-bariatric complications seen most commonly in sleeve gastrectomy and Roux-en-Y gastric bypass.

PRESENTATION OF CASE

A 50-year-old menopausal female with a body mass index (BMI) of 38 was admitted with acute abdominal pain 10 days after one-anastomosis gastric bypass (OAGB). Her lab tests were normal, but in her abdominal CT scan with IV contrast, subacute complete intraluminal thrombosis with luminal expansion at the left branch of the portal vein and its segmental branches was seen. Her diagnostic laparoscopy was normal, and she was discharged with no symptoms and a prescription for rivaroxaban.

DISCUSSION

PMVT is one of the complications after bariatric surgery that is very uncommon and fetal. It has been seen more in laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass, and early diagnosis of PMVT is essential due to its high mortality rate and cause of gastrointestinal ischemia.

CONCLUSION

In this case report, we saw that PMVT could happen after OAGB, and it is important to consider PMVT as one of the complications after OAGB to not miss the cases.

摘要

引言

肥胖是一种严重的状况,会导致糖尿病、高血压等非传染性疾病。肥胖症在全球的患病率增长非常迅速,因此随着减肥手术(肥胖症最有效的治疗方法)效果的显现,接受减肥手术的人数也在增加。门静脉肠系膜静脉血栓形成(PMVT)是减肥手术后罕见的致命并发症之一,最常见于袖状胃切除术和Roux-en-Y胃旁路手术。

病例介绍

一名50岁的绝经后女性,体重指数(BMI)为38,在接受单吻合口胃旁路手术(OAGB)10天后因急性腹痛入院。她的实验室检查结果正常,但在腹部增强CT扫描中,可见门静脉左支及其分支节段内有亚急性完全腔内血栓形成并伴有管腔扩张。她的诊断性腹腔镜检查结果正常,出院时无症状,并开具了利伐沙班的处方。

讨论

PMVT是减肥手术后的并发症之一,非常罕见且致命。在腹腔镜袖状胃切除术和Roux-en-Y胃旁路手术中更为常见,由于其高死亡率和胃肠道缺血的原因,PMVT的早期诊断至关重要。

结论

在本病例报告中,我们发现OAGB术后可能发生PMVT,将PMVT视为OAGB术后的并发症之一很重要,以免漏诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e09/10570941/e404288b19e5/gr1.jpg

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