title: Iatrogenic kwashiorkor after distal gastric bypass surgery: the consequences of receiving multinational treatment.
abstract: Protein-calorie malnutrition or kwashiorkor is extremely rare after gastric bypass surgery. We report a case of a woman referred to a weight management clinic in the United Kingdom who developed bilateral leg oedema 2 years after gastric bypass surgery in Tunisia. Her serum albumin concentration was 24 g/l, and her body mass index was 16.2 kg/m(2). A review of the postoperative report of her bariatric surgery revealed that she had undergone a distal bypass with anastomosis of the intestine at 1 m proximal to the ileocaecal valve. She required gastrostomy feeding for 6 months before undergoing revisional surgery to a proximal Roux-en-Y gastric bypass in order to restore healthy weight. We recommend that if patients are having their bariatric surgery outside of their country of residence, they should always obtain a copy of the operative notes so that these are readily available if complications arise.
authors.affiliation: Department of Clinical Biochemistry, Russells Hall Hospital, Dudley, UK.
authors.forename: R
authors.initials: R
authors.lastname: Pitt
authors.affiliation: Department of Surgery, Torbay Hospital, Devon, UK.
authors.forename: P L Z
authors.initials: PL
authors.lastname: Labib
authors.affiliation: Department of Radiology, Russells Hall Hospital, Dudley, UK.
authors.forename: A
authors.initials: A
authors.lastname: Wolinski
authors.affiliation: Weight Management Clinic, Russells Hall Hospital, Dudley, UK.
authors.forename: M H
authors.initials: MH
authors.lastname: Labib
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007049:Iatrogenic Disease; D038622:Internationality; D007732:Kwashiorkor / Q000209:etiology* / Q000601:surgery; D008499:Medical Records; D011183:Postoperative Complications; D012086:Reoperation; D014416:Tunisia; D006113:United Kingdom