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Multidetector Computed Tomography Evaluation of Mesenteric Venous Thrombosis Following Laparoscopic Bariatric Surgery

Dane, Bari; Clark, Jaclyn; Megibow, Alec

Journal of Computer Assisted Tomography: January 2017 - Volume 41 - Issue 1 - p 56–60
doi: 10.1097/RCT.0000000000000473
Abdominal Imaging

Objective: The purpose of this study is to review multidetector computed tomography (CT) imaging findings of mesenteric venous thrombosis occurring following bariatric surgery. To our knowledge, this complication has not been described in the radiologic literature.

Methods: Multidetector CT examinations of 6 patients known to have developed mesenteric venous thrombosis after laparoscopic bariatric surgery were reviewed. The thrombus was characterized, and associated imaging findings including presence of mesenteric edema, small bowel edema, and thrombotic complications were described.

Results: Four patients underwent laparoscopic sleeve gastrectomy approximately 12 days before CT diagnosis of mesenteric thrombosis and 2 patients had a laparoscopic Roux-en-Y gastric bypass approximately 11 years before imaging diagnosis of mesenteric thrombosis.

The thrombus occupied the entire length of the superior mesenteric vein in all cases. Extension into jejunal branches was present in 4 cases. The thrombus was completely occlusive in 4 of 6 patients.

Conclusions: Mesenteric venous thrombosis is an increasingly recognized complication of laparoscopic bariatric surgery. Awareness demands that postbariatric surgery patients with acute abdominal pain be studied with intravenous contrast material.

From the *Division of Abdominal Imaging, Department of Radiology and †Department of Surgery, NYU Langone Medical Center, New York, NY.

Received for publication March 14, 2016; accepted May 5, 2016.

Correspondence to: Bari Dane, Department of Radiology, Division of Abdominal Imaging, NYU Langone Medical Center, 560 First Ave, New York, NY, 10016 (e-mail: bari.dane@nyumc.org).

The authors declare no conflict of interest.

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