Deep vein thrombosis and intraperitoneal hemorrhage after thrombolysis: rare complication of laparoscopic varicocelectomy

A rare case of a patient who had an uncommon complication of deep vein thrombosis (DVT) and intraperitoneal hemorrhage after thrombolysis following laparoscopic Varicocelectomy (LV) is reported in this paper. The patient was a 31-year-old man, experienced the treatment with bilateral LV because of infertility. Color Doppler Ultrasound (CDU) showed DVT, and then percutaneous implantation of inferior vena cava filter (IVCF) and catheter directed thrombolysis (CDT) were performed during the treatment. After the urokinase thrombolytic therapy, the patient was diagnosed intraperitoneal hemorrhage and was treated with laparoscopic exploration. The patient recovered favorably, being discharged by oral anticoagulation therapy and supported by compression elastic bandages for 6 months. It is concluded that DVT following LV should be paid more attention and it is also critical to have a high index of suspicion for intraperitoneal hemorrhage after thrombolysis. Laparoscopic exploration should be used as a minimally invasive approach because of its clear advantages over open surgery.