Portomesenteric venous thrombosis post gastric sleeve

The gastric sleeve is the most performed bariatric surgery, and several studies have shown a good safety profile. Among its main postoperative complications are bleeding, leak, stenosis, reflux and to a lesser extent, portomesenteric venous thrombosis (1%). More than 80% of this entity occur after discharge. Diagnosis is difficult because it does not have characteristic symptoms or laboratory abnormalities. A 30-year-old male with a body mass index of 40.2 kg/m², submitted to gastric sleeve, developing tachycardia, abdominal pain and oral intolerance on the eighth postoperative day. Contrast-enhanced abdominopelvic tomography revealed thrombosis of the portal, mesenteric and splenic veins. Portomesenteric venous thrombosis managed with resection, laparoscopic entero-entero anastomosis and anticoagulation. Although the risk of presenting portomesenteric venous thrombosis is relatively low, its complications are serious and life-threatening, in addition to an increased prevalence in bariatric surgeries.