Obesity surgery and Ehlers-Danlos syndrome: challenges and considerations based on a case report.

We present the first case of bariatric surgery in a patient with Ehlers-Danlos syndrome and outline management challenges in the context of the relevant literature. A 56-year-old man with type IV Ehlers-Danlos syndrome and a body mass index of 41.8 kg/m2 was referred to the bariatric centre of the Churchill Hospital, Oxford, for consideration of surgery for morbid obesity. His comorbidity included type 2 diabetes, hypertension, dyslipidaemia and obstructive sleep apnoea. He underwent a laparoscopic Roux-en-Y gastric bypass. His initial recovery was uneventful and he was discharged on the first postoperative day. Six weeks later, he presented with 43.9% excess weight loss and improved glycaemic control. Three months postoperatively, however, he complained of dysphagia, regurgitation and postprandial pain. A barium meal and gastroscopy suggested the presence of a gastric diverticulum. A surgical exploration was planned. Intraoperative gastroscopy demonstrated an asymmetrical gastric pouch dilatation and the pouch was therefore refashioned laparoscopically. Despite the initial symptomatic relief, two months later he experienced retrosternal pain with progressive dysphagia. Since then, multiple endoscopic dilatations of the gastro-oesophageal junction have been performed for recurrence of symptoms. Finally, a laparoscopic hiatus hernia repair and adhesiolysis was performed resulting in complete relief of patient's symptoms. Bariatric management of patients with Ehlers-Danlos synd...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research

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Source: Asia Pacific Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Asia Pac J Clin Nutr Source Type: research
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Source: Asia Pacific Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Asia Pac J Clin Nutr Source Type: research
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Source: Asia Pacific Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Asia Pac J Clin Nutr Source Type: research
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Source: Asia Pacific Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Asia Pac J Clin Nutr Source Type: research
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Source: Asia Pacific Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Asia Pac J Clin Nutr Source Type: research
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Source: Asia Pacific Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Asia Pac J Clin Nutr Source Type: research
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