title: [A case of Pickwickian syndrome with improvement of obesity-related sleep apnea following vertical banded gastroplasty].
abstract: The patient was 22-year-old male who had suffered from hypermotility during sleep and excessive daytime sleepiness, and 270% in excess body weight. Values of arterial blood gas analysis during sleep were 65mmHg in PaCO2 and 19mmHg in PaO2. He was diagnosed as morbid obesity with Pickwickian syndrome and underwent vertical banded gastroplasty. His body weight decreased from 170kg to 113kg four months after surgery and 107kg one year after surgery. The whole-night polyhypnographic sleep study was performed before and after operation and showed dramatic improvement of apnea index which was calculated by dividing the number of apneas by the total sleep time. We analyzed 199 case reports which had noted symptoms of Pickwickian syndrome between 1963 and 1989 in Japan. In many reported cases, body weight decreased transiently but returned to the level before medical treatment. Under these considerations, gastroplasty is a beneficial surgical treatment for the morbid obesity with Pickwickian syndrome.
authors.affiliation: Second Department of Surgery, Chiba University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miyauchi
authors.forename: I
authors.initials: I
authors.lastname: Kawamura
authors.forename: K
authors.initials: K
authors.lastname: Soeda
authors.forename: K
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Y
authors.initials: Y
authors.lastname: Miyazawa
authors.forename: K
authors.initials: K
authors.lastname: Isono
mesh_terms: D000328:Adult; D001835:Body Weight; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D008297:Male; D010845:Obesity Hypoventilation Syndrome / Q000150:complications* / Q000503:physiopathology; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D012890:Sleep