Oh Min Woo, Gu Min Su, Kong Hyun Ho
Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju 28644, South Korea.
World J Clin Cases. 2021 Mar 16;9(8):1909-1915. doi: 10.12998/wjcc.v9.i8.1909.
The causes of peroneal neuropathy are various, but are rarely due to weight loss. Bilateral peroneal neuropathy caused by weight loss after surgery has been reported only after bariatric surgery and there were no reports associated with other abdominal surgery. In this report, we describe a case of the bilateral peroneal neuropathy that occurred due to marked weight loss after biliary surgery.
A 58-year-old male did not receive adequate nutritional support after biliary surgery, and showed a massive weight loss over a short period of time (body mass index; 24.1 kg/m to 20.5 kg/m for 24 d). Then, foot drop occurred on both sides. Physical examination, electromyography (EMG) and magnetic resonance imaging studies were conducted and he was diagnosed as bilateral common peroneal neuropathy around the fibular head level. The patient was treated electrical stimulation therapy on both lower legs along with exercise therapy, and received sufficient oral nutritional support. The patient gradually recovered to his original weight, and the power of the dorsiflexor of bilateral ankles improved after conservative treatment. In addition, the follow-up EMG showed signs of improvement.
Any abdominal surgery that may have rapid and marked weight loss can lead to peroneal neuropathy as a complication.
腓总神经病变病因多样，但因体重减轻导致者罕见。仅在减肥手术后有报道称手术后体重减轻可引起双侧腓总神经病变，尚无与其他腹部手术相关的报道。在本报告中，我们描述了1例因胆道手术后体重显著减轻而发生双侧腓总神经病变的病例。
1例58岁男性在胆道手术后未获得足够的营养支持，在短时间内体重大幅下降（24天内体重指数从24.1kg/m降至20.5kg/m）。随后双侧出现足下垂。进行了体格检查、肌电图（EMG）和磁共振成像检查，诊断为双侧腓骨头水平的腓总神经病变。对患者双下肢进行了电刺激治疗并辅以运动疗法，同时给予了充足的口服营养支持。患者体重逐渐恢复至原有水平，经保守治疗后双侧踝关节背屈肌力量改善。此外，随访肌电图显示有改善迹象。
任何可能导致迅速且显著体重减轻的腹部手术都可能引发腓总神经病变这一并发症。
