Mesenteric Venous Thrombosis After Laparoscopic Sleeve Gastrectomy: Pathophysiology and Literature Review
Bibliographic record
Abstract
In the last 10 years, laparoscopic sleeve gastrectomy has become an increasingly popular surgical option for morbidly obese patients. Mesenteric venous thrombosis, as a complication of laparoscopic sleeve gastrectomy, has been rarely reported. We report two cases of thrombosis of the superior mesenteric vein after sleeve gastrectomy. It is confirmed by CT scan. Treatment is primarily medical. Three months later, the patients were asymptomatic still under antivitamin K. Thrombosis of the superior mesenteric vein after bariatric surgery is a diagnosis that one should know how to raise in front of any postoperative abdominal pain. The laparoscopic abdominal pressure ( > 14 mm Hg), associated with a marked position in bariatric surgery, reduces the venous flow by 50% which may increase the risk of thrombosis. In addition, soft tissue trauma during surgery (manipulation of the small intestine during short gastric bypass or duodenal switch) releases tissue factors that could cause a mesenteric venous thrombosis in patients with a previously undiagnosed hypercoagulable state. The clinical signs of mesenteric venous ischemia are variable and nonspecific. The etiology of portal thrombosis must be done before the introduction of heparin therapy which is not always possible in emergency. An obese patient with a history of thrombosis should receive a complete etiology of these thromboses before bariatric surgery. Abnormal blood dirt, an active smoking fat woman having oral contraceptive, or a patient with a history of recurrent venous thrombosis may be a relative contraindication against a complex bariatric surgery with digestive bypass. J Curr Surg. 2014;4(3):101-104 doi: http://dx.doi.org/10.14740/jcs229w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".