Document Detail


Postmortem findings in morbidly obese individuals dying after gastric bypass procedures.
MedLine Citation:
PMID:  17239934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mortality has been reported to complicate gastric bypass, with common causes of death attributable to anastomotic leaks, sepsis, hemorrhage, and bowel obstruction. We evaluated autopsy reports from 10 patients having undergone gastric bypass. Medical records were reviewed to identify comorbidities. Data of interest included preoperative electrocardiogram (EKG) abnormalities, cause of death, body weight, anastamosis appearance, heart weight, extent of coronary artery disease, ventricular size, liver weight, and gall bladder status. A total of 7 men and 3 women were autopsied. Average age was 40 years (range, 30-49 years), and mean body mass index at autopsy was 60.3 kg/m(2) (range, 33.2-80.9 kg/m(2)). Evidence of anastomotic leaks was present in 7 cases, resulting in 4 deaths. Death was attributed to pulmonary embolism in one case. There were 5 cardiac-related deaths, all attributed to arrhythmias. Microscopic evidence of coronary artery disease was observed in 6. Cardiomegaly was seen in all patients, left ventricular hypertrophy in 8, right ventricular hypertrophy in 3, and hepatomegaly in all 10. Nine patients were status post cholecystectomy. Of the 8 preoperative EKG available, abnormalities were identified in 5. After gastric bypass, death was attributed to cardiac-related causes, pulmonary embolism, and operative complications. A significant proportion of cardiac-related deaths occured in the absence of atherosclerosis. Most patients had preoperative EKG abnormalities. As a high incidence of cardiomegaly was observed, operative stress associated with the procedure may increase the risk of arrhythmia in morbid obesity. Consequently, in morbidly obese patients, a detailed preoperative cardiovascular evaluation is warranted to reduce postoperative mortality.
Authors:
Peter M Cummings; Brian H Le; M Beatriz S Lopes
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Publication Detail:
Type:  Journal Article     Date:  2007-01-19
Journal Detail:
Title:  Human pathology     Volume:  38     ISSN:  0046-8177     ISO Abbreviation:  Hum. Pathol.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-19     Completed Date:  2007-05-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421547     Medline TA:  Hum Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  593-7     Citation Subset:  IM    
Affiliation:
Division of Autopsy and Neuropathology, Department of Pathology, University of Virginia Health System, Charlottesville, VA 22908-0214, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arrhythmias, Cardiac / mortality
Autopsy
Cause of Death
Female
Gastric Bypass / adverse effects*,  mortality
Humans
Male
Middle Aged
Obesity, Morbid / complications,  mortality,  surgery*
Postoperative Complications / mortality
Pulmonary Embolism / mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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