Gouty attacks occur frequently in postoperative gastric bypass patients.
BACKGROUND
Both obesity and surgery are known risk factors for instigating gouty attacks. We describe the incidence and management of postoperative gouty attacks after bariatric surgery.


METHODS
We performed a retrospective, multi-institutional review of 411 consecutive laparoscopic gastric bypass patients and identified all patients with postoperative gouty attacks.


RESULTS
Of the 411 patients reviewed, 21 (5.1%) had had a previous diagnosis of gout. Of these 21 patients, 7 (33.3%) had had an acute attack postoperatively. No patient who had never had a preoperative episode developed gout. In 4 of the 7 (57.1%) patients, the attack was severe enough to require treatment with corticosteroids. Monoarticular attacks occurred in 5 (71.4%) of the 7 patients, and polyarticular attacks occurred in 2 (28.6%). The joints involved included the toes, ankles, and wrists. One patient presented with cervical gout and developed polyarticular gout that required a significant rehabilitation stay.


CONCLUSIONS
The morbidity of postoperative gouty attacks in bariatric surgery patients is significant. Patients with a history of gout should given prophylactic treatment and closely monitored.
Friedman
Jeffrey E
JE
Sacred Heart Institute for Surgical Weight Loss, Pensacola, Florida 32503, USA.
Dallal
Ramsey M
RM
Lord
Jeffrey L
JL
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors