Catastrophic weight loss after vertical banded gastroplasty: malnutrition and neurologic alterations

The case of a patient with severe vomiting and very rapid weight loss following vertical banded gastroplasty (VBG) (almost 50% of original weight in 11 months) and who suffered severe neurological and nutritional disorders is reported. All abnormal findings with the exception of nystagmus, disappeared during enteral nutritional support with a complete diet and vitamin supplementation. The alterations found in this case may have been related to the very rapid weight loss, which resulted in protein calorie malnutrition and, probably, in one or more vitamin deficiencies. This complication may be preventable by early nutritional intervention in subjects undergoing gastric reduction surgery and who exhibit very rapid weight loss and intractable vomiting.