Trombosis mesentérica y portal tras funduplicatura de Nissen laparoscópica / Fatal portal thrombosis after laparoscopic Nissen fundoplication
Rev. esp. enferm. dig
; 97(9): 666-669, sept. 2005.
Article
in Es
| IBECS
| ID: ibc-042738
Responsible library:
ES1.1
Localization: ES1.1 - BNCS
RESUMEN
La trombosis venosa mesentérica y portal es una complicacióninfrecuente de la cirugía laparoscópica. Presentamos el caso de unvarón de 20 años, consumidor de cocaína inhalada, al que se realizauna funduplicatura de Nissen laparoscópica, administrándose20 mg de enoxaparina (Clexane®, Aventis Pharma, Spain) preoperatoriamente.El séptimo día postoperatorio, el paciente presentauna trombosis venosa mesentérica y portal, que se confirmaen la laparotomía, con necrosis de todo el intestino delgado y segmentariadel colon, falleciendo el paciente a las 24 horas, a pesarde la terapia anticoagulante y confirmándose el diagnóstico en lanecropsia.La trombosis mesentérica y portal es una complicación infrecuentre,pero grave y potencialmente mortal, de la cirugía laparoscópicadel reflujo gastroesofágico. Cuando se asocian variosfactores predisponentes con un potencial trombótico demostradoaislado, como la cirugía laparoscópica y el consumo de cocaína,no parece que las dosis habituales de profilaxis tromboembólicasean suficientes para evitar esta grave complicación
ABSTRACT
Portal and mesenteric vein thrombosis is a very uncommoncomplication of laparoscopic surgery, especially after anti-refluxprocedures. We report the case of a twenty-year-old man with ahistory of alcohol and cocaine consumption. A Nissen fundoplicationwas performed. The patient received a single 20-mg dose ofenoxaparin (Clexane®, Aventis Pharma, Spain) two hours beforesurgery for antithrombotic prophylaxis. On the seventh postoperativeday the patient had a portal and mesenteric venous thrombosis,which was confirmed at laparotomy, with both extensivesmall-intestine necrosis and partial colon necrosis. Despite anticoagulanttherapy, the patient died 24 hours later. Surgical findingswere confirmed at necropsy.Portal and mesenteric venous thrombosis is an uncommon butsevere and even fatal complication after laparoscopic anti-refluxsurgery. When other pro-thrombotic, predisposing conditionssuch as laparoscopic surgery and cocaine consumption are present,the usual prophylactic doses of low molecular weight heparinmight not be sufficient to protect against this life-threateningcomplication
Full text:
Available
Collection:
National databases
/
Spain
Health context:
SDG3 - Health and Well-Being
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
/
SDG3 -Target 3.5 Prevention and treatment of consumption of psychoactive substances
Health problem:
Target 3.5: Prevention and treatment of consumption of psychoactive substances
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Cardiovascular Disease
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Digestive System Diseases
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Venous Thromboembolic Disease
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Alcohol
Database:
IBECS
Main subject:
Portal Vein
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Laparoscopy
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Fundoplication
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Venous Thrombosis
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Mesenteric Veins
Type of study:
Etiology study
/
Risk factors
Limits:
Adult
/
Humans
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Male
Language:
Spanish
Journal:
Rev. esp. enferm. dig
Year:
2005
Document type:
Article
Institution/Affiliation country:
HospitalUniversitario Marqués de Valdecilla/España