Rhabdomyolysis after sleeve gastrectomy: increase in muscle enzymes does not predict fatal outcome.
BACKGROUND
Rhabdomyolysis (RML) is a clinical and biochemical syndrome caused by destruction of skeletal muscles and constitutes a complication of bariatric surgery, with an incidence near to 22%. It is accompanied by increase in serum of intracellular enzymes. Laboratory data as predictive of prognosis have been evaluated by some authors. We report a case of RML after a sleeve gastrectomy, with good prognosis despite a very extensive muscle damage and very high seric and urinary peaks of intracellular enzymes.


METHODS
We describe a 34-years-old super-obese male (body mass index, 54.3 kg/m2) who underwent to laparoscopic sleeve gastrectomy. After 24 h, patient complained of pain in gluteal region, oliguria, and high levels of creatine phosphokinase that reached to 58,395 IU/l. Acute renal failure related to RML was diagnosed. Dialysis was not necessary. Ambulatorial control of renal function after dimission did not reveal a permanent damage.


CONCLUSIONS
RML is a biochemical syndrome recently associated with bariatric surgery. Early diagnosis is ever necessary. Laboratory data represent markers for diagnosis and prognostic indicator of renal failure. There is no clear relation between seric levels of intracellular enzymes and irreversible renal damage and RML-related mortality.
Foresteri
Pietro
P
Department of General, Geriatric and Oncologic Surgery and Advanced Technology, Università degli Studi Federico II, Via S. Pansini 5, 1-80132 Naples, Italy. forestie@unina.it
Pietro
Forestieri
F
Formato
Antonio
A
Antonio
Formato
F
Pilone
Vincenzo
V
Vincenzo
Pilone
P
Romano
Antonietta
A
Antonietta
Romano
R
Monda
Antonietta
A
Angela
Monda
M
Tramontano
Salvatore
S
Salvatore
Tramontano
T
D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects*; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy