Successful thrombolysis of submassive XXXX after bariatric surgery: expanding the indications and addressing the controversies.

@entity1 @entity28 @entity1353 @entity548 @entity16960 @entity1151 @entity551 @entity887 @entity67 @entity1211 @entity204
BACKGROUND: @entity1211 ( @entity1211 ) disease is a much-feared complication of bariatric surgery. The most common unexpected cause of @entity204 in the morbidly @entity28 @entity1 is @entity1151 ( @entity1151 ). Recent data supports the expanded use of systemic thrombolytics in hemodynamically stable @entity1 with @entity1151 and echocardiographic evidence of @entity67 . METHODS: We report a morbidly @entity28 28-year-old female who presented with @entity1353 3 weeks following bariatric surgery. The @entity1 developed a submassive @entity1151 , despite being on low molecular weight (LMW) heparin ( @entity16960 ) postoperatively. The @entity1 was admitted to the surgical intensive care unit of an urban community teaching hospital and underwent successful thrombolysis. RESULTS: Although the @entity1 was not @entity551 , she was tachycardic and highly symptomatic. Spiral CT scanning revealed a large saddle @entity887 . Transthoracic echocardiography revealed moderate-to-severe acute @entity67 with paradoxical septal motion. The @entity1 was started on i.v. heparin followed by an infusion of alteplase 100 mg i.v. over 2 hours. She had no mental status changes during the infusion or evidence of @entity548 . She had a rapid improvement of her symptoms. Repeat CT scanning revealed marked resolution of the @entity1151 . She was discharged home in excellent condition. CONCLUSION: To our knowledge, this is the first report of systemic thrombolysis for a submassive @entity1151 after bariatric surgery in a hemodynamically stable @entity1 with @entity67 . Given the high incidence and morbidity of @entity1211 in this population, and the expanding indications for thrombolytic therapy, successful cases such as these should be documented.
