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Published on: June 11, 2012
Gouty attacks occur frequently in postoperative gastric bypass patients
Jeffrey E Friedman1, Ramsey M Dallal, Jeffrey L Lord
1Sacred Heart Institute for Surgical Weight Loss, Pensacola, Florida 32503, USA.
Insights
Postoperative gout attacks occurred in 33.3% of bariatric surgery patients with a history of gout. Patients with prior gout diagnosis require close monitoring and prophylactic treatment to prevent acute attacks after surgery.
Area of Science:
- Bariatric Surgery
- Gout Management
- Postoperative Complications
Background:
- Obesity and surgical procedures are recognized triggers for gout flares.
- This study focuses on the occurrence and treatment of gout attacks following bariatric surgery.
Purpose of the Study:
- To determine the incidence of postoperative gouty attacks in patients undergoing bariatric surgery.
- To describe the management strategies for these attacks.
Main Methods:
- A retrospective review of 411 laparoscopic gastric bypass patients was conducted.
- Patients experiencing postoperative gouty attacks were identified and analyzed.
Main Results:
- 5.1% of patients had a prior gout diagnosis; 33.3% of these experienced postoperative attacks.
- No new gout cases developed in patients without a prior history.
- Corticosteroids were required in 57.1% of affected patients; attacks were often monoarticular, affecting joints like toes, ankles, and wrists.
Conclusions:
- Postoperative gout attacks present significant morbidity in bariatric surgery patients.
- Prophylactic treatment and vigilant monitoring are crucial for patients with a history of gout.
Background:
Both obesity and surgery are known risk factors for instigating gouty attacks. We describe the incidence and management of postoperative gouty attacks after bariatric surgery.
Methods:
We performed a retrospective, multi-institutional review of 411 consecutive laparoscopic gastric bypass patients and identified all patients with postoperative gouty attacks.
Results:
Of the 411 patients reviewed, 21 (5.1%) had had a previous diagnosis of gout. Of these 21 patients, 7 (33.3%) had had an acute attack postoperatively. No patient who had never had a preoperative episode developed gout. In 4 of the 7 (57.1%) patients, the attack was severe enough to require treatment with corticosteroids. Monoarticular attacks occurred in 5 (71.4%) of the 7 patients, and polyarticular attacks occurred in 2 (28.6%). The joints involved included the toes, ankles, and wrists. One patient presented with cervical gout and developed polyarticular gout that required a significant rehabilitation stay.
Conclusion:
The morbidity of postoperative gouty attacks in bariatric surgery patients is significant. Patients with a history of gout should given prophylactic treatment and closely monitored.
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