Rhabdomyolysis after biliopancreatic diversion with duodenal switch

Area of Science:

• Bariatric Surgery
• Nephrology
• Surgical Complications

Background:

• Rhabdomyolysis is a rare but serious complication following bariatric surgery.
• Risk factors include ischemia, crush injury, alcohol, and drug intake, potentially leading to renal failure.
• Obese patients undergoing bariatric procedures are identified as a population at risk.

Observation:

• A case report details a super-obese male (BMI 52 kg/m2) who underwent a lengthy laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS).
• Postoperatively, the patient experienced hip and shoulder pain, oliguria, and developed acute kidney injury requiring hemodialysis.
• Despite supportive treatment, the patient succumbed to arrhythmia and cardiac arrest on the 8th postoperative day.

Findings:

• Prolonged muscle compression during lengthy laparoscopic bariatric surgeries can predispose patients to rhabdomyolysis.
• This case highlights the potential for severe outcomes, including fatal cardiac events, in patients developing rhabdomyolysis post-bariatric surgery.
• Early recognition and management of rhabdomyolysis are crucial in the postoperative care of bariatric surgery patients.

Implications:

• Bariatric surgical teams should be vigilant for signs of rhabdomyolysis in the postoperative period.
• Strategies to mitigate prolonged muscle compression during long laparoscopic procedures may be warranted.
• Further research into the incidence and prevention of rhabdomyolysis in bariatric surgery is recommended.