Portosystemic shunt surgery for severe portal hypertension due to portal thrombosis after bariatric surgery

J Surg Case Rep. 2024 Apr 24;2024(4):rjae254. doi: 10.1093/jscr/rjae254. eCollection 2024 Apr.

Abstract

Portal vein thrombosis is a rare complication after laparoscopic sleeve gastrectomy, a widely performed bariatric surgery procedure. Occasionally, the development of portal vein thrombosis can progress to more severe conditions, including portal hypertension and cavernomatosis, thereby presenting a complex and challenging clinical scenario. The management of such complications often requires careful consideration; however, surgical intervention in the form of a splenorenal shunt is an exceptional indication. We present the case of a 33-year-old female patient who had previously undergone laparoscopic sleeve gastrectomy in 2014 and subsequently developed portal thrombosis, followed by cavernomatosis and associated complications of portal hypertension. A proximal splenorenal shunt procedure and splenectomy were successfully performed to manage portal hypertension. The presentation of this clinical case aims to contribute to the available evidence and knowledge surrounding this rare and challenging pathology.

Keywords: bariatric surgery; portal hypertension; portosystemic shunt.

Publication types

  • Case Reports