Abstract
Background: Pleural effusion is a rare complication of sleeve gastrectomy. It has many possible etiologies, including gastric leakage, gastropleural fistula formation, splenic abscess, and complications related to administered medications, such as spontaneous hemothorax secondary to anticoagulants. Case Presentation: An unusual case of a 46-year-old woman was reported, who was presented to the emergency room (ER) 10 days after laparoscopic sleeve gastrectomy complaining of dyspnea, chest pain, and dry cough for 4 days. Imaging confirmed massive pleural effusion on the left side. The patient showed improvement after intensive care unit (ICU) admission and drainage via the chest tube. Conclusion: Sleeve gastrectomies are associated with several complications. Low-molecular-weight heparin (LMWH) as prophylaxis for portal vein thrombosis leads to a spontaneous hemothorax. Unfortunately, computed tomography with contrast could not be performed because of vital instability. However, it was concluded that a massive spontaneous hemothorax occurred due to LMWH. The patient was admitted to ICU and underwent slow drainage of pleural effusion until complete recovery
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