Severe protein-calorie malnutrition after bariatric procedures

• Published in: Obesity surgery Vol. 14; no. 2; pp. 175 - 181
• Main Authors: Faintuch, Joel, Matsuda, Mitsunori, Cruz, Maria Emilia L F, Silva, Marlene M, Teivelis, Marcelo P, Garrido, Jr, Arthur B, Gama-Rodrigues, J J
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01.02.2004
• Subjects: Adult; Anastomosis, Roux-en-Y - adverse effects; Body Mass Index; Female; Gastric Bypass - adverse effects; Gastrointestinal surgery; Humans; Male; Malnutrition; Middle Aged; Morbidity; Mortality; Obesity; Obesity, Morbid - surgery; Protein-Energy Malnutrition - etiology; Protein-Energy Malnutrition - mortality; Proteins; Retrospective Studies; Risk Factors; Stomach - surgery; Surgical outcomes
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1381/096089204322857528

Serious nutritional complications after Roux-en-Y gastric bypass (RYGBP) are infrequent. In a retrospective study of patients operated during a 68-month period, malnutrition was investigated to analyze circumstances associated with nutritional failure. In 236 consecutive RYGBPs, 11 patients with severe malnutrition were identified (4.7%) with age 45.1 +/- 10.6 years (10 females/1 male) and initial BMI 54.6 +/- 8.4 kg/m(2). In these 11 patients, the derangement was diagnosed 17.9 +/- 15.8 months after RYGBP, following defined events in 63.6% (gastric stenosis, associated diseases ) or mostly exaggeration of expected symptoms in 36.4% (vomiting without endoscopic abnormalities). BMI then was 31.4 +/- 8.6 kg/m(2) (42.5 +/- 9.9% total reduction, or 2.4 +/- 2.1% decrease/month), and serum albumin and hemoglobin were 24.0 +/- 8.2 g/L and 97.0 +/- 23.0 g/L respectively. Edema was present in 45.4% (5/11), hospitalization was required in 54.5% (6/11), and 18.2% (2/11) eventually died. Serious malnutrition was unusual but not exceedingly rare in this series. Exogenous precipitating factors were clearly identified in 63.6% of the patients. Careful clinical and nutritional follow-up is recommended to prevent these uncommon but potentially dangerous complications.