肠系膜上静脉血栓形成作为腹腔镜袖状胃切除术后罕见并发症：病例报告及文献综述

摘要(中文译文)

腹腔镜袖状胃切除术（LSG）是一种常见的减重手术，并发症发生率相对较低。然而，门肠系膜静脉血栓形成（PMVT）是术后可能发生的一种少见但严重的并发症。若未能早期诊断，该病可导致肠缺血。我们报道一例49岁女性患者，患有肥胖症（BMI 60.9 kg/m）、高血压和糖尿病，在接受LSG术后20天发生PMVT。患者表现为严重的上腹痛、恶心和腹泻。影像学检查显示肠系膜上静脉和门静脉血栓形成，实验室检查提示多种促血栓形成因素，包括凝血因子V Leiden突变和抗凝血酶III水平降低。患者接受抗凝治疗，出院时改用华法林并密切监测INR。本病例强调了LSG术后早期发现和有效治疗PMVT的至关重要性。包括血液科和血管外科会诊在内的多学科协作对于预防并发症和改善患者预后至关重要。

Abstract

Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure with relatively low complication rates. However, portomesenteric venous thrombosis (PMVT) is an uncommon serious complication that can occur after surgery. If not diagnosed early, this condition can lead to intestinal ischemia. We present the case of a 49-year-old woman with obesity (BMI 60.9 kg/m), hypertension, and diabetes mellitus, who developed PMVT 20 days after undergoing LSG. She presented with severe epigastric pain, nausea, and diarrhea. Imaging revealed thrombosis in the superior mesenteric and portal veins, laboratory tests indicated multiple prothrombotic factors, including factor V Leiden mutation and reduced Antithrombin III levels. The patient was managed with anticoagulation therapy and was discharged on warfarin with close INR monitoring. This case highlights the critical importance of early detection and effective treatment of PMVT after LSG. A multidisciplinary approach, including hematology and vascular surgery consultations, is crucial to prevent complications and improve patient outcomes.

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