Laparoscopically performed gastric banding in a 13 year-old girl with morbid obesity and end stage renal insufficiency allows lifesaving weight loss and hemodialysis.
OBJECTIVE
In adults, laparoscopic gastric banding is applied to treat morbid obesity, usually in combination with dietary and psychological intervention and increased physical exercise. However, little information is available on gastric banding in children.


METHODS
The 13 year-old girl suffered from end stage renal failure. Complications with hemodialysis catheters due to her extensive subcutaneous fat pads led to a life-threatening deterioration of her uremia. Intensive conventional schedules for weight reduction failed to be effective, so the morbidly obese girl (body mass index [BMI] 37.7 kg/m2, +3.6 standard deviation score [SDS]) underwent laparoscopic gastric banding at the age of 13 years after informed parental consent was obtained.


RESULTS
After laparoscopic gastric banding there was a notable weight loss of 14 kg and an eventually adequate hemodialysis was possible. Total weight loss of the now 15 year-old girl was 24 kg (present BMI 28.3 kg/m2, +2.2 SDS).


CONCLUSIONS
Even in childhood, laparoscopic gastric banding may be considered in cases of morbid obesity in critically ill patients.
Department of Pediatrics, University of Erlangen-Nuremberg, Germany. ina.knerr@kinder.imed.uni-erlangen.de
I
I
Knerr
T
T
Horbach
C
C
Plank
R
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Carbon
K D
KD
Nüsken
W
W
Rascher
J
J
Dötsch
D000293:Adolescent; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D015992:Body Mass Index; D015444:Exercise / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D005858:Germany; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000175:diagnosis; D010535:Laparoscopy / Q000379:methods*; D009767:Obesity, Morbid / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D010349:Patient Compliance; D010353:Patient Education as Topic; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D006178:Romani People; D013997:Time Factors; D014511:Uremia / Q000150:complications; D014807:Vitamin D / Q000494:pharmacology / Q000627:therapeutic use; D015431:Weight Loss / Q000502:physiology*
D000959:Antihypertensive Agents; D014807:Vitamin D