title: Diagnosis of celiac disease during pre-operative work-up for bariatric surgery.
abstract: OBJECTIVE
  Morbid obesity is a highly prevalent condition. In selected cases, bariatric surgery is indicated. Although for decades celiac disease (CD) has been associated with chronic diarrhea and weight loss, now it becomes clear that the clinical spectrum is extremely wide.
  
  
  METHODS
  We report 5 morbidly obese patients that were diagnosed of CD during preoperative work-up for bariatric surgery. Diagnosis was suspected during routine upper endoscopy, and confirmed by histology and positive CD-specific serology.
  
  
  RESULTS
  Four of the 5 cases were asymptomatic. One complained of chronic diarrhea and anemia. All cases initiated a gluten-free diet. Due to CD, patients were offered a purely restrictive bariatric procedure. Three patients underwent a sleeve gastrectomy while the other two are still undergoing pre-operative evaluations.
  
  
  CONCLUSIONS
  This report enlarges the clinical spectrum of untreated CD. Although prevalence of CD in obese patients seems to be similar to that in the general population, morbid obese patients should be tested for CD in order to establish the best surgical strategy and outcome.
authors: Department of Surgery, Dr C Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina.
authors: Federico
authors: F
authors: Cuenca-Abente
authors: Fabio
authors: F
authors: Nachman
authors: Julio C
authors: JC
authors: Bai
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis*; D020776:Endoscopes, Gastrointestinal; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011300:Preoperative Care