Roux-en-Y Gastric Bypass and the Clinical Manifestations of Vitamin Deficiencies: Case Report and Literature Review.

Autor:	Innes TA; Internal Medicine, Quillen College of Medicine at East Tennessee State University, Johnson City, USA., Massey SR; Internal Medicine, Quillen College of Medicine at East Tennessee State University, Johnson City, USA., Magacha HM; Internal Medicine, Quillen College of Medicine at East Tennessee State University, Johnson City, USA., Vedantam V; Internal Medicine, Quillen College of Medicine at East Tennessee State University, Johnson City, USA., Vedantam N; Infectious Diseases, Quillen College of Medicine at East Tennessee State University, Johnson City, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Mar 13; Vol. 16 (3), pp. e56101. Date of Electronic Publication: 2024 Mar 13 (Print Publication: 2024).
DOI:	10.7759/cureus.56101
Abstrakt:	This case outlines the complications of Roux-en-Y gastric bypass surgery (RYGBS) and demonstrates clinical manifestations of several vitamin deficiencies. We present a 45-year-old female patient who was admitted to our hospital with generalized weakness, anasarca, hypotension, and failure to thrive, a year after she had her RYGBS. After the procedure, she had nausea, vomiting, and diarrhea with progressive inability to tolerate any oral intake. Subsequently, the patient lost over 200 pounds and got bedridden. Initially, after the procedure, the patient had a dilatation of her anastomotic stricture, but after her surgeon moved out of town she was lost to follow up until she presented to our hospital. Upon arrival, the patient was hypotensive, tachycardic, and appeared dehydrated. The exam also revealed several clinical manifestations of vitamin deficiencies including dermatitis concerning Pellagra, follicular hyperkeratosis, and Bitot spots. Laboratory data showed significantly low albumin, protein, acute kidney injury, and several electrolyte abnormalities. The patient had to be admitted to the ICU for pressure support along with colloid and electrolyte replacement. An Esophagogastroduodenoscopy (EGD) was performed which revealed a clean-based ulcer and a 10-mm anastomotic stricture. She was started on Total Parenteral Nutrition (TPN). After the dilatation of the stricture, the patient was able to tolerate oral intake and TPN was subsequently discontinued upon discharge. The patient was educated extensively on the importance of compliance with daily vitamin supplementation and regular follow-up with bariatric physicians at discharge. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Innes et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu