Mesenteric Vein Thrombosis after Laparoscopic Right Colectomy - A Case Report and Literature Review

Abstract

Introduction: Mesenteric vein thrombosis (MVT) is a rare but serious condition. Prompt diagnosis and early treatment are essential to avoid high mortality from this condition. Very few cases of this complication after laparoscopic colon resection have been reported in the literature. Presentation of case: We report superior mesenteric vein thrombosis in a 69-year old male after uneventful laparoscopic right colectomy for colon cancer. Incidental diagnosis of MVT was made on staging CT scan of abdomen one month after surgery. He was promptly treated with anticoagulation which avoided adverse outcomes. The patient was asymptomatic throughout the course of the disease. Discussion: There is significant lack of its awareness about this disease in medical fraternity due to very low incidence. Additionally, signs and symptoms are often confusing especially in patients who have had recent surgery. Pain abdomen, nausea, and diarrhea are most common symptoms. High degree of clinical suspicion by treating physician is the key to early diagnosis. Undiagnosed patients have high mortality due to consequent mesenteric ischemia and sepsis. CT angiography is the most important diagnostic test and prompt systemic anticoagulation is the treatment of choice. Conclusion: Awareness of this condition and a high index of suspicion are two most important attributes in fighting with this deadly and rare complication after laparoscopic colon resection.