A Survivor of Chronic Disseminated Intravascular Coagulation (DIC) after a Gastric Bypass Surgery

Though, the overall risk of death and adverse outcomes after bariatric surgery is low, the severity of complications and related mortality should never be underestimated. Here we report a 59-year-old Caucasian female who suffered but survived from chronic disseminated intravascular coagulation (DIC) three months after her laparoscopic Roux-en-Y gastric bypass (RYGBP) surgery. The patient developed intra-abdominal abscess and multiple venous thromboses. Most of workup for coagulopathy was negative except elevated D-dimer and fibrinogen to 2841 ng/ml and 860 mg/dL respectively. A chronic DIC was diagnosed. The patient was put on a heparin drip after exploratory laparotomy. Then she was successfully bridged to Coumadin and discharged. Surgical patients for gastric bypass with higher risks of venous thrombosis should be considered for aggressive peri-operative prophylactic anti-coagulation, and lower threshold for early work up.