title: Severe hypoalbuminemia and steatohepatitis leading to death in a young vegetarian female, 8 months after mini gastric bypass: A case report.
abstract: BACKGROUND
  Hypoalbuminemia is an important complication after Mini Gastric Bypass (MGB) and is more frequent in vegetarians, diabetic nephropathy, and alcoholic and liver disease patients. The patients must be followed in regular intervals and serum albumin must be checked in every visit after MGB. Hypoalbuminemia must be prevented by good protein regimes.
  
  
  METHODS
  A 29 years old female was admitted 8 month after Laparoscopic Mini Gastric Bypass with malaise, dyspnea, icter, nausea, vomiting, diarrhea and edema of extremities from 2 weeks before admission. She had become vegetarian autonomously and had not participated in routine postop follow up, and also discontinued her high protein regimen. In para clinictest results, she had severe hypoalbuminemia, anemia, elevated liver enzymes and direct bilirubinemia, metabolic acidosis in Arterial Blood Gas (ABG), and in Core Needle Biopsy (CNB) marked Steatohepatitis was shown. Unfortunately, the patient did not respond to medical care and died.
  
  
  CONCLUSIONS
  Regular follow up after Mini Gastric Bypass is very important for many reasons such as early diagnosis and treatment of hypoalbuminemia.
authors.affiliation: Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: mkermansaravi@yahoo.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Kermansaravi
authors.affiliation: Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: mra_75@yahoo.com.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Abdolhosseini
authors.affiliation: Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran; Comprehensive Cancer Center, Wexner Medical Center, Ohio State University, Columbus, OH, USA. Electronic address: aikabir@yahoo.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Kabir
authors.affiliation: Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran; Center of Excellence for Minimally Invasive Surgery Training, Iran University of Medical Sciences, Tehran, Iran; Center of Excellence of European Branch of International Federation for Surgery of Obesity, Tehran, Iran. Electronic address: apazouki@yahoo.com.
authors.forename: Abdolreza
authors.initials: A
authors.lastname: Pazouki
keywords: Case report; Death; Gastric bypass; Hypoalbuminemia; Steatohepatitis; Vegetarian