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Adrenal insufficiency following bariatric surgery
J W Stephens1, K Boregowda, J Barry
1Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, ABM University Health Board, Swansea, Wales, UK.
Summary
Bariatric surgery, specifically biliopancreatic diversion, can lead to unexpected adrenal insufficiency. This case highlights the importance of long-term monitoring for hormonal imbalances after such procedures.
Area of Science:
- Endocrinology
- Gastroenterology
- Bariatric Surgery
Background:
- Morbid obesity poses significant health risks, often necessitating bariatric surgery.
- Biliopancreatic diversion (BPD) is a malabsorptive procedure effective for weight loss but carries risks of nutritional deficiencies.
Observation:
- A patient who underwent BPD experienced weight loss and restored menstruation but later developed symptoms of severe vitamin deficiencies and fatigue.
- Despite vitamin replacement, persistent lethargy and dizziness suggested an underlying issue beyond nutritional deficits.
Findings:
- The patient exhibited severe deficiencies in vitamins A and D, iron, and calcium, alongside low cholesterol.
- Suboptimal adrenocorticotropic hormone stimulation tests indicated secondary adrenal insufficiency.
- This is the first reported case of adrenal insufficiency following biliopancreatic diversion.
Implications:
- Biliopancreatic diversion may precipitate adrenal insufficiency, necessitating vigilant long-term endocrine monitoring.
- Early diagnosis and hormone replacement are crucial for managing post-BPD adrenal insufficiency and improving patient outcomes.
- This finding expands the spectrum of potential complications associated with malabsorptive bariatric surgeries.
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