Case Report: Extensive Dermatitis Secondary to Severe Malnutrition, Zinc and Vitamin Deficiencies After Malabsorptive Bariatric Surgery

Bariatric surgery is one of the most effective treatments currently available for obesity and its derived comorbidities. However, complications may occur, especially when malabsorptive surgeries like a biliopancreatic diversion is performed. We present the case of a female patient whose obesity was treated with this technique, and in the 9th year of follow-up developed an extensive dermatitis secondary to zinc deficiency and malnutrition, precipitated by therapeutic non-compliance. A close surveillance of early symptoms and signs of nutritional deficiencies as well as chronic supplementation of vitamins and trace elements is required; this case illustrates the relevance of periodical, lifelong visits to a medical physician with special training and experience in the management of post bariatric surgery patients in order to prevent, diagnosis and early treat related complications.

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A Very Rare Cause of Dilated Cardiomyopathy after Bariatric Surgery: Selenium Deficiency

Surgical Case Reports ◽

10.31487/j.scr.2021.08.20 ◽

2021 ◽

pp. 1-3

Author(s):

Gulay Kocak ◽

Munevver Gul Avsar ◽

Cansu Yazar ◽

Aylia Yesilova ◽

Gulcagri Yildiz ◽

...

Keyword(s):

Bariatric Surgery ◽

Trace Elements ◽

Sleeve Gastrectomy ◽

Dilated Cardiomyopathy ◽

Selenium Deficiency ◽

Water Soluble ◽

Nutritional Deficiencies ◽

Reduced Ejection Fraction ◽

Long Term Follow Up

Background: Sleeve gastrectomy for weight loss has increased significantly nowadays. Various complications may develop after this surgery that requires long-term follow-up of these patients. Nutrition is the most important aspect of the follow-up. The deficiency of trace elements, fat-soluble and water-soluble vitamins following bariatric surgeries have been well-described complications. Although nutritional supplementations are often initiated after bariatric surgery, the clinical outcomes related to the deficiency of trace elements have not been well known yet. Case Presentation: A 27-year-old woman who underwent a laparoscopic sleeve gastrectomy for surgical treatment of obesity 9 months ago presented to the emergency department with a signs of heart failure. Transthoracic echocardiography revealed dilated, poorly functioning left ventricle with reduced ejection fraction (28.9%) consistent with dilated cardiomyopathy. We assumed nutritional deficiencies secondary to sleeve gastrectomy as a cause of dilated cardiomyopathy, as the patient had inappropriate nutritional supplements after surgery. Laboratory tests revealed selenium and zinc deficiency that supported our hypothesis. Our patient completely recovered with adequate supplementation of selenium, zinc and thiamine. Conclusion: We highlighted that the early diagnosis of dilated cardiomyopathy due to selenium deficiency following bariatric surgery is of great importance since selenium deficiency is a cause of reversible cardiomyopathy.

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Nutritional Deficiencies

10.1093/med/9780199937837.003.0184 ◽

2017 ◽

Author(s):

Deanna Saylor ◽

John C. Probasco

Keyword(s):

Bariatric Surgery ◽

Developing Countries ◽

Nervous System ◽

Nutritional Deficiencies ◽

Neurologic Manifestations ◽

Neurological Manifestations ◽

Biochemical Activity ◽

Vitamin Deficiencies ◽

Post Bariatric Surgery ◽

Developed World

Nutritional deficiencies are estimated to affect at least one third of the world’s population. Although they are most common in developing countries, they are also found in the developed world where they often occur in the setting of alcoholism, eating disorders, post bariatric surgery, and malabsorptive disorders. Neurologic manifestations of vitamin deficiencies are varied, reflecting the diversity of biochemical activity of vitamins throughout the nervous system. Here the neurological manifestations of common vitamin deficiencies are examoned, beginning with a discussion of relevant biochemistry and pathophysiology of each respective vitamin. Several micronutrients are included in the tables within this chapter.

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Third reported case of rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-En-Y gastric bypass: case report and literature review

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/s40519-021-01154-z ◽

2021 ◽

Author(s):

Yassmin Salaheldin ◽

Walid El Ansari ◽

Esraa Aljaloudi ◽

Wahiba Elhag

Keyword(s):

Bariatric Surgery ◽

Gastric Bypass ◽

Risk Factor ◽

Case Report ◽

Zinc Deficiency ◽

Nutritional Deficiencies ◽

Level Of Evidence ◽

Necrolytic Migratory Erythema ◽

High Index Of Suspicion

Abstract Introduction Obesity is a risk factor for zinc deficiency. After bariatric surgery, non-compliance to diet/vitamin supplements, surgical complications leading to vomiting/diarrhea, poor follow-up and malabsorption can precipitate or exacerbate pre-existing zinc deficiency. Case report We report a patient with rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-en-Y gastric bypass (following primary laparoscopic sleeve gastrectomy). Conclusion Bariatric teams should screen patients before bariatric surgery for nutritional deficiencies and continue surveillance of their nutritional status after surgery. They should maintain a high index of suspicion for zinc deficiency in patients with skin rash after bariatric surgery. Level of evidence Level V, case report.

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Invasive candida infection after bariatric surgery for morbid obesity presenting as late anastamotic leak

10.52768/jjgastro/1025 ◽

2021 ◽

Vol 1 (5) ◽

Author(s):

Jayanth Moode ◽

◽

KASSN Kalyan ◽

Lakshmi Kona ◽

◽

...

Keyword(s):

Bariatric Surgery ◽

Fungal Infections ◽

Mini Gastric Bypass ◽

Diagnostic Tools ◽

Invasive Candida Infection ◽

Mortality Case ◽

Gastrointestinal Candidiasis ◽

High Index Of Suspicion ◽

Post Bariatric Surgery

Introduction: Gastrointestinal (GI) leaks are one of the most dreaded complications following bariatric surgery because of the difficulty in diagnosing them and the associated increased morbidity and mortality. Case report: Presenting one such case of 49 yr old gentleman who was on follow-up post bariatric surgery presented lately as acute abdomen and diagnosed as GI perforation and further evaluation and procedure carried out. Discussion: GI leakage after bariatric surgery has been identified as an independent risk factor associated with perioperative death. This highlights the importance of high index of suspicion for diagnosis of this potentially lethal complication. A positive radiology should not be awaited for before exploring patients in whom the diagnosis is still unclear. Conclusion: Histopathologic examination (HPE) remains one of the major diagnostic tools in mycology because it permits rapid, presumptive identification of fungal infections, even when blood cultures are negative. There are different ways to manage leaks, depending on the magnitude of the collection and the clinical presentation. Keywords: surgical pathology; gastrointestinal candidiasis; diagnosis; mini gastric bypass; bariatric surgery; candida.

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Long-Term Follow-up of a Recurrent Multifocal Desmoid Tumour Treated with Tamoxifen: A Case Report

Journal of Orthopaedic Surgery ◽

10.1177/230949900501300213 ◽

2005 ◽

Vol 13 (2) ◽

pp. 174-177 ◽

Cited By ~ 6

Author(s):

DP Gwynne-Jones ◽

JC Theis ◽

AK Jeffery ◽

NA Hung

Keyword(s):

Case Report ◽

Female Patient ◽

Tamoxifen Treatment ◽

Desmoid Tumour ◽

Pelvic Tumour ◽

Local Recurrences ◽

Long Term Follow Up

We report a long-term follow-up of a female patient with a multifocal extremity desmoid tumour. She had 3 local recurrences after excision and developed a second unresectable pelvic tumour that has remained unchanged in size for 14 years since starting tamoxifen treatment.

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Prevalence of All-Cause Mortality and Suicide among Bariatric Surgery Cohorts: A Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15071519 ◽

2018 ◽

Vol 15 (7) ◽

pp. 1519 ◽

Cited By ~ 12

Author(s):

Russell Lim ◽

Melvyn Zhang ◽

Roger Ho

Keyword(s):

Bariatric Surgery ◽

Analytical Study ◽

Meta Analysis ◽

Well Being ◽

Mortality Rates ◽

Pooled Prevalence ◽

All Cause Mortality ◽

Bariatric Patients ◽

Post Bariatric Surgery

Introduction: Prior meta-analysis has reported mortality rates among post-operative bariatric patients, but they have not considered psychiatric factors like suicide contributing to mortality. Objectives: The current meta-analysis aims to determine the pooled prevalence for mortality and suicide amongst cohorts using reported suicides post bariatric surgery. It is also the aim of the current meta-analytical study to determine moderators that could account for the heterogeneity found. Results: In our study, the pooled prevalence of mortality in the studies which reported suicidal mortality was 1.8% and the prevalence of suicide was 0.3%. Mean body mass index (BMI) and the duration of follow-up appear to be significant moderators. Conclusions: Given the prevalence of suicide post bariatric surgery, it is highly important for bariatric teams to consider both the medical and psychiatric well-being of individuals pre- and post-operatively.

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Nutritional Deficiencies and Bariatric Surgery

10.1093/med/9780190608347.003.0014 ◽

2018 ◽

Author(s):

Anthony B. Mozer ◽

Konstantinos Spaniolas ◽

Walter J. Pories

Keyword(s):

Bariatric Surgery ◽

Oral Intake ◽

Emergency Department Visits ◽

Nutritional Deficiencies ◽

Vitamin Supplementation ◽

Behavioral Modification ◽

Poor Oral Intake ◽

Preoperative Counseling ◽

Disproportionate Number

Dietary intolerance and poor oral intake account for a disproportionate number of emergency department visits and readmissions after bariatric surgery. Micronutrient, vitamin, and protein deficiencies can occur after both malabsorptive and restrictive weight-loss operations, and they are best mitigated against by conscientious preoperative counseling and vigilance in follow-up. Routine vitamin supplementation can prevent the need for unnecessary laboratory testing, while symptoms of dumping syndrome can frequently be managed with dietary and behavioral modification alone. Alternative enteral feeding access for alimentary supplementation can be safely performed surgically or with assistance by interventional radiology, and should be considered in the management of perforation, early anastomotic leak, surgical revision, or patients with refractory malnourishment.

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Direct Laminate Veneers with Resin Composites: Two Case Reports with Five-Year Follow-ups

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-11-4-56 ◽

2010 ◽

Vol 11 (4) ◽

pp. 56-62 ◽

Cited By ~ 1

Author(s):

Yusuf Ziya Bayindir ◽

Yahya Orcun Zorba ◽

Cagatay Barutcugil

Keyword(s):

Case Report ◽

Female Patient ◽

Composite Laminate ◽

Case Reports ◽

Treatment Plan ◽

Resin Composites ◽

Enamel Hypoplasia ◽

Anterior Teeth ◽

Laminate Veneers

Abstract Aim The aim of this report is to present five-year follow-ups of two different applications for the use of direct laminate resin-based composite veneers to improve esthetics. Background Defects in the maxillary anterior teeth, such as enamel hypoplasia and peg lateral, can present esthetic challenges. Furthermore, a treatment plan that can be completed in a single appointment is highly desirable. This case report presents two different clinical cases involving the use of direct laminate resin-based composite veneers with five-year follow-ups. Case Report Case 1: A 17-year-old female patient was referred for treatment of her anterior teeth, which were unesthetically altered due to enamel hypoplasia and dental caries. A treatment plan was developed that included restoring the affected teeth with direct resin-based composite laminate veneers to improve the patient's appearance. The six maxillary anterior teeth were prepared for and restored with direct resinbased composite laminate veneers. At the fiveyear follow-up, the patient was satisfied with the restorations both esthetically and functionally. Case 2: A 15-year-old female patient also was referred for treatment to improve the appearance of her maxillary anterior teeth. A treatment plan was developed with two objectives: (1) to restore the undersized supernumerary crown in the area of the maxillary right lateral incisor and (2) to close the anterior diastemas. The facial surfaces were conservatively prepared and resin-based composite was applied with the aid of transparent crown forms. After completion of the treatment, the patient was recalled at six-month intervals. At the five-year follow-up appointment, the restorations were intact, no adverse effects were noted, and the resultant appearance was highly satisfactory for the patient. Summary The use of direct resin-based composite laminate veneers and adhesive bonding systems has been shown to provide an esthetic alternative to metal-ceramic or all-ceramic crowns for the rehabilitation of anterior teeth. This treatment option offers another advantage, namely a lower cost compared to an indirect technique. Other more complex and costly treatment options in the future are not ruled out. Clinical Significance In the present two cases, the initial and five-year follow-up results support the use of direct resin-based composite laminate veneers with minimal altering of healthy tooth structure. Such results should encourage clinicians to seek a cost-effective technique such as direct resin restorations to improve a patient's esthetic appearance in a single appointment. Citation Zorba YO, Bayindir YZ, Barutcugil C. Direct Laminate Veneers with Resin Composites: Two Case Reports with Five-Year Follow-ups. J Contemp Dent Pract [Internet]. 2010 July; 11(4):056-062. Available from: http://www. thejcdp.com/journal/view/volume11-issue4-zorba

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