title: Methamphetamine use following bariatric surgery in an adolescent.
abstract: Bariatric surgery is increasingly popular as a therapeutic strategy for morbidly obese adolescents. Adolescence represents a sensitive period of psychosocial development, and children with considerable weight loss may experience greater peer acceptance, accompanied by both positive and negative influences. Substance abuse exists as one of these negative influences. We present the case of an adolescent bariatric surgical patient who abused methamphetamines in the postoperative period, with consequent nutritional instability. A concerted effort must be made in the preoperative assessment of adolescent bariatric patients to delineate a history of illicit drug use, including abuse of diet pills and stimulants. Excessive postoperative weight loss or micronutrient supplementation non-compliance should raise a suspicion of stimulant use and appropriate screening tests should be performed. The consequent appetite suppression may manifest with signs of malnutrition such as bradycardia, hypotension, and weakness. Inpatient nutritional rehabilitation and psychiatric assessment should be considered.
authors.affiliation: Department of Surgery, Lucile Packard Children's Hospital, Stanford University Medical Center, Stanford, CA 94305, USA. sdutta1@stanford.edu
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Dutta
authors.forename: John
authors.initials: J
authors.lastname: Morton
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shepard
authors.forename: Rebecka
authors.initials: R
authors.lastname: Peebles
authors.forename: Susan
authors.initials: S
authors.lastname: Farrales-Nguyen
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Hammer
authors.forename: Craig T
authors.initials: CT
authors.lastname: Albanese
mesh_terms: D000293:Adolescent; D001919:Bradycardia / Q000209:etiology; D000697:Central Nervous System Stimulants; D003681:Dehydration / Q000209:etiology; D005260:Female; D015390:Gastric Bypass / Q000523:psychology; D006801:Humans; D044342:Malnutrition / Q000209:etiology; D008694:Methamphetamine; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery; D010349:Patient Compliance; D011184:Postoperative Period; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine