Document Detail

Rapidly evolving liver decompensation with some remarkable features 14 years after biliopancreatic derivation: a case report and literature review.
MedLine Citation:
PMID:  20458850     Owner:  NLM     Status:  MEDLINE    
Because of the rising incidence of obesity the use of bariatric surgery is also increasing. For the obese it is the only treatment with a proven long-term benefit on weight, comorbidities including non alcoholic steatohepatitis, and long-term mortality. There are, however, several reports on hepatic complications after bariatric surgery leading to malabsorption. The risk of liver decompensation or cirrhosis is one of the reasons jejunoileal bypass has been abandoned. Hepatic complications following Roux-en-Y gastric bypass and biliopancreatic derivation (BPD) are also reported but never beyond 2 years of follow-up. There is only one confirmed case of development of cirrhosis following BPD which presented 10 months after surgery. We present a case of a 39-year-old patient who developed rapidly evolving, and ultimately fatal, liver decompensation in previously unknown cirrhosis, 14 years after BPD. This is the first report of a severe hepatic complication such a long time after a BPD. Existing literature on hepatic complications after bariatric surgery is discussed as are 2 coincidental findings of pronounced ductular reaction on histology and autoimmune haemolytic anaemia.
J L van Dongen; P P Michielsen; G G Van den Eynden; P A Pelckmans; S M Francque
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Acta gastro-enterologica Belgica     Volume:  73     ISSN:  0001-5644     ISO Abbreviation:  Acta Gastroenterol. Belg.     Publication Date:    2010 Jan-Mar
Date Detail:
Created Date:  2010-05-12     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0414075     Medline TA:  Acta Gastroenterol Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  46-51     Citation Subset:  IM    
Antwerp University Hospital, Department of Gastroenterology and Hepatology, Wilrijkstraat 10, 2650 Edegem, Belgium.
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MeSH Terms
Biliopancreatic Diversion / adverse effects*
Liver Cirrhosis / diagnosis,  etiology*,  therapy
Obesity / complications,  pathology,  surgery
Time Factors

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