Abstract
Data continue to grow regarding the safety and technical feasibility of laparoscopically assisted total mesorectal excision (TME). As this minimally invasive alternative to open colonic resection becomes more popular, it is inevitable that information on the benefits and complications associated with it will continue to expand. Portal vein thrombosis (PVT) has been reported after a variety of laparoscopic procedures. We report a case of superior mesenteric, splenic and portal vein thrombosis following laparoscopically assisted TME. To our knowledge, this complication of laparoscopic TME has not been previously reported in the literature. PVT should be ruled out in patients who present with vague abdominal symptoms. The course of this complication, while potentially devastating, is usually benign and responds well to lysis and/or anticoagulation.
Similar content being viewed by others
References
Abdelrazeq AS, Dwaik MA, Aldoori MI et al (2006) Laparoscopy-associated portal vein thrombosis: description of an evolving clinical syndrome. J Laparoendosc Adv Surg Tech A 16:9-4
Wang JT, Zhao HY, Liu YL (2005) Portal vein thrombosis. Hepatobiliary Pancreat Dis Int 4:515-18
Poultsides GA, Lewis WC, Feld R et al (2005) Portal vein thrombosis after laparoscopic colectomy: thrombolytic therapy via the superior mesenteric vein. Am Surg 71:856-60
Valeri A, Venneri F, Presenti L et al (1998) Portal thrombosis. A rare complication of laparoscopic splenectomy. Surg Endosc 12:1173-176
Steele SR, Martin MJ, Garafalo T et al (2003) Superior mesenteric vein thrombosis following laparoscopic Nissen fundoplication. JSLS 7:159-63
Ishizaki Y, Bandai Y, Shimomura K et al (1993) Changes in splanchnic blood flow and cardiovascular effects following peritoneal insufflation of carbon dioxide. Surg Endosc 7:420-23
Rasmussen IB, Berggren U, Arvidsson D et al (1995) Effects of pneumoperitoneum on splanchnic hemodynamics: an experimental study in pigs. Eur J Surg 161:819-26
Epstein RM, Wheeler HO, Frumin MJ et al (1961) The effect of hypercapnia on estimated hepatic blood flow, circulating splanchnic blood volume, and hepatic sulfobromophthalein clearance during general anesthesia in man. J Clin Invest 40:592-98
Hidajat N, Stobbe H, Griesshaber V et al (2005) Portal vein thrombosis: etiology, diagnostic strategy, therapy and management. Vasa 34:81-2
Hidajat N, Stobbe H, Griesshaber V et al (2005) Imaging and radiological interventions of portal vein thrombosis. Acta Radiol 46:336-43
Webster GJ, Burroughs AK, Riordan SM (2005) Review article: portal vein thrombosis - new insights into aetiology and management. Aliment Pharmacol Ther 21:1–9
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vadalà, S., Cinardi, N., Li Volti, G. et al. Portal vein thrombosis following laparoscopic total mesorectal excision: case report. Tech Coloproctol 12, 259–261 (2008). https://doi.org/10.1007/s10151-008-0418-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10151-008-0418-6