Alarfaj Hamzah M, Alrasheed Wedyan Y, Alsulaiman Sumaiyah A, Almulhem Fai T, Almaideni Meriam F, Alkuwaity Khalid W
Internal Medicine, King Fahad Hospital - Al-Hofuf, Al-Ahsa, SAU.
Medicine, King Faisal University, Al-Ahsa, SAU.
Cureus. 2021 Dec 6;13(12):e20198. doi: 10.7759/cureus.20198. eCollection 2021 Dec.
Obesity can promote several metabolic, cardiovascular, and musculoskeletal complications and has been associated with poor quality of life. The treatment of obesity can range from simple lifestyle modifications or medications to complicated bariatric surgeries. Although bariatric surgery has been a proven treatment for morbid obesity, it has also been associated with multiple consequences and complications. Several reports and studies have revealed bone loss or decreased bone mineral density (BMD), fractures, or even several metabolic bone diseases, such as osteoporosis, following bariatric surgery. This case report aims to increase awareness on postoperative patient supplementation compliance and incorporation of early detection and intervention. This case report involves a 39-year-old male who underwent laparoscopic biliopancreatic diversion 10 years prior to presentation. The patient was not compliant with his supplements for over nine years, which lead to multiple fragility fractures, myopathy, and muscle atrophy due to hypocalcemia, vitamin D deficiency, hyperparathyroidism, and other electrolyte disturbances. He has since been treated with supplements and physiotherapy for 10 months and showed clinical improvement. This case report highlights the importance of pre- and postoperative screening of bone loss risks and any vitamin or mineral deficiencies with subsequent correction via supplements. Moreover, it emphasizes the need for more studies on the complications of late post-bariatric surgeries.
肥胖会引发多种代谢、心血管和肌肉骨骼方面的并发症,并与生活质量低下有关。肥胖的治疗方法多种多样,从简单的生活方式改变或药物治疗到复杂的减肥手术。尽管减肥手术已被证明是治疗病态肥胖的有效方法,但它也会带来多种后果和并发症。多项报告和研究表明,减肥手术后会出现骨质流失或骨密度(BMD)降低、骨折,甚至一些代谢性骨病,如骨质疏松症。本病例报告旨在提高对术后患者补充剂依从性以及早期检测和干预的认识。本病例报告涉及一名39岁男性,他在就诊前10年接受了腹腔镜胆胰分流术。该患者九年多来一直未遵医嘱服用补充剂,由于低钙血症、维生素D缺乏、甲状旁腺功能亢进和其他电解质紊乱,导致多处脆性骨折、肌病和肌肉萎缩。此后,他接受了10个月的补充剂治疗和物理治疗,临床症状有所改善。本病例报告强调了术前和术后筛查骨质流失风险以及任何维生素或矿物质缺乏情况,并随后通过补充剂进行纠正的重要性。此外,它强调需要对减肥手术后晚期并发症进行更多研究。