Brañes A, Orellana M, Muñoz R. Systemic thrombolysis for acute submassive pulmonary embolism after laparoscopic Roux-en-Y bypass: A case report.
Int J Surg Case Rep 2019;
55:66-68. [PMID:
30703719 PMCID:
PMC6354619 DOI:
10.1016/j.ijscr.2019.01.005]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/23/2018] [Accepted: 01/15/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION
Venous thromboembolism (VTE) in bariatric surgery is a low incidence disease; however, it is the first cause of morbimortality in this group of patients.
PRESENTATION OF THE CASE
We present the case of a female patient with morbid obesity who was readmitted due to an acute submassive bilateral pulmonary embolism (PE) nineteen days after a laparoscopic Roux-en-Y gastric bypass (RYGB). After diagnosis, anticoagulation was initiated, and decision to add mechanical and pharmacological thrombolysis was made with the patient been successfully treated, as shown by normalization of pulmonary hypertension.
DISCUSSION
VTE in bariatric surgery is rare but contributes to significant morbidity and mortality in patients undergoing bariatric surgery.
CONCLUSION
It is necessary to have a high index of suspicion to make a timely diagnosis and initiate an early treatment. In selected cases, adding mechanical and pharmacological thrombolysis could increase chance of reverse pulmonary hypertension.
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