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Rhabdomyolysis following laparoscopic gastric bypass
D Filis1, M Daskalakis, I Askoxylakis
1Bariatric Unit, Department of Surgical Oncology, Medical School, University of Crete, Heraklion, Crete, Greece.
Obesity Surgery
|December 16, 2005
Summary
Rhabdomyolysis, a serious skeletal muscle injury, can occur after prolonged surgery, especially in obese patients. Prompt treatment with hydration and pain relief is crucial to prevent severe complications like kidney failure.
Area of Science:
- Medicine
- Surgery
- Nephrology
Background:
- Rhabdomyolysis is a critical syndrome resulting from skeletal muscle breakdown.
- It presents with muscle pain, elevated creatine phosphokinase, myoglobinuria, and can lead to renal failure and death if untreated.
Observation:
- Prolonged intraoperative immobilization is a primary risk factor for postoperative rhabdomyolysis.
- Morbidly obese patients undergoing lengthy laparoscopic bariatric surgery are particularly vulnerable due to immobilization and pressure effects.
Findings:
- A 20-year-old female with a BMI of 51 developed rhabdomyolysis post-laparoscopic Roux-en-Y gastric bypass.
- She experienced severe gluteal and lumbar myalgia, oliguria, and extremely high creatine phosphokinase levels (38,700 U/L).
Implications:
- Immediate diagnosis and treatment, including intensive hydration and analgesics, prevented acute renal failure in this high-risk patient.
- This case highlights the importance of vigilance for rhabdomyolysis in obese patients undergoing prolonged laparoscopic procedures.
