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 UNUSUAL CASE
Year : 2017  |  Volume : 13  |  Issue : 2  |  Page : 143-145

Portomesenteric venous thrombosis: A rare but probably under-reported complication of laparoscopic surgery: A case series


1 Department of Upper Gastrointestinal Surgery, Lancashire Teaching Hospitals NHS Trust, Preston, UK
2 Department of Radiology, Lancashire Teaching Hospitals NHS Trust, Preston, UK
3 Department of Colorectal Surgery, Lancashire Teaching Hospitals NHS Trust, Preston, UK

Correspondence Address:
Ravindra S Date
The University of Manchester, Manchester Academic Health Science Centre, Lancashire Teaching Hospital NHS Foundation Trust, Chorley PR7 1PP
UK
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.195582

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Portomesenteric venous thrombosis (PMVT) is a rare but well-reported complication following laparoscopic surgery. We present three cases of PMVT following laparoscopic surgery. Our first case is a 71-year-old morbidly obese woman admitted for elective laparoscopic giant hiatus hernia (LGHH) repair. Post-operatively, she developed multi-organ dysfunction and computed tomography scan revealed portal venous gas and extensive small bowel infarct. The second patient is a 51-year-old man with known previous deep venous thrombosis who also had elective LGHH repair. He presented 8 weeks post-operatively with severe abdominal pain and required major bowel resection. Our third case is an 86-year-old woman who developed worsening abdominal tenderness 3 days after laparoscopic right hemicolectomy for adenocarcinoma and was diagnosed with an incidental finding of thrombus in the portal vein. She did not require further surgical intervention. The current guidelines for thromboprophylaxis follow-up in this patient group may not be adequate for the patients at risk. Hence, we propose prolonged period of thromboprophylaxis in the patients undergoing major laparoscopic surgery.






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