Portal vein thrombosis after laparoscopic cholecystectomy

Background

There exist multiple complications related to laparoscopic cholecystectomy, whether the procedure or the technique adopted. Portal vein thrombosis (PVT) is a rare complication observed in several procedures and exceptionally rare following laparoscopic cholecystectomy.

Case presentation

a 35-year-old lady on oral contraceptives for 15 years presented to the emergency department 5 days post uneventful laparoscopic cholecystectomy with epigastric pain and tenderness. She was found to have proximal portal vein thrombosis on computed tomography. The patient was treated with weight-based therapeutic low molecular weight heparin. Symptoms resolved and she was discharged on direct oral anticoagulant for 3 months. A repeated scan showed recanalization of the portal vein.

Conclusion

PVT is a rare complication post laparoscopic cholecystectomy, though it should be one of the differential diagnosis for a patient presenting with abdominal symptoms post-surgery, even without having associated risk factors. A high index of suspicion should be maintained and if confirmed, investigations for risk factors are crucial for the appropriate management.