title: Rhabdomyolysis after bariatric surgery.
abstract: BACKGROUND
  Rhabdomyolysis is a potential threat after bariatric surgey. The severity ranges from asymptomatic elevations of serum muscle enzyme levels to life-threatening cases associated with muscle necrosis, compartment syndrome, acute renal failure and cardiac arrest.
  
  
  METHODS
  We studied 98 consecutive obese patients who underwent primary uncomplicated bariatric surgery during a 1-year period. A database was created for all patients (sex, age, BMI, duration of the operation); serum creatinine phosphokinase (CPK) was systematically measured before surgery and on the first and second postoperative day.
  
  
  RESULTS
  The study sample consisted of 35 males (35.7%) and 63 females (64.3%) with preoperative CPK level 156.6 +/- 41.1 U/L (40 to 220), 24 hours postoperatively 1,075.2 +/- 596.5 U/L, (85 to 2,790 U/L) and 48 hours postoperatively 967.3 +/- 545.3 U/L (79 to 2,630). There was no difference in mean BMI (P=0.1) and mean duration of operation (P=0.5) between males and females. However, a statistically significant difference in mean elevation of CPK between males and females (P=0.003) was found. The variables sex, age, weight and duration of surgery were analyzed by multivariate logistic regression, but did not show a statistically significant difference.
  
  
  CONCLUSIONS
  Rhabdomyolysis is a potentially fatal complication of surgical procedures in obese patients, and can be minimized with simple measures such as additional padding, aggressive hydration and urine alkalinization. Diagnosis requires a high level of physician awareness.
authors.affiliation: Department of Surgery, Londrina State University, Londrina, Brazil. carvalhodecio@uol.com.br
authors.forename: Décio Alexandre
authors.initials: DA
authors.lastname: de Freitas Carvalho
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Valezi
authors.forename: Edvaldo Macedo
authors.initials: EM
authors.lastname: de Brito
authors.forename: José Carlos Lacerda
authors.initials: JC
authors.lastname: de Souza
authors.forename: Antonio César
authors.initials: AC
authors.lastname: Masson
authors.forename: Tiemi
authors.initials: T
authors.lastname: Matsuo
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012206:Rhabdomyolysis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D013997:Time Factors
chemical_list: D003402:Creatine Kinase