First case report of disseminated intravascular coagulopathy associated with severe micronutrient deficiency and protein malnutrition following sleeve gastrectomy

Abstract

Disseminated Intravascular Coagulopathy (DIC) is a serious acquired hematological syndrome with intravascular activation of the coagulation process in which both microvascular thrombosis and life-threatening bleeding can occur depending on the balance between utilization of platelets, inhibitors, and coagulation factors. (DIC) can manifest in either an acute or chronic form and almost always arises as a secondary complication of an underlying disease, trauma, or clinical condition. Various causes identified with infection and cancer being on the top of the list, though, idiopathic cases were also reported. Bariatric and metabolic surgery (BMS) is one of the treatment lines for obesity with a low mortality rate. However, its associated with certain medical and /or hematological complications secondary to nutritional deficiencies such as protein/albumin malnutrition, low iron, copper, and B 12 deficiencies, causing anemia, and pancytopenia. DIC in post gastric bypass surgery has been previously reported. However, its occurrence after Sleeve Gastrectomy (SG) remains unclear and has not been previously reported.