Evidence map›Paper›PMID 39397355›Full record

ArticleThe American journal of case reports2024

Dual Hepatic Injury from Refeeding Syndrome and Starvation in a Malnourished Woman After Bariatric Surgery: A Case Report.

Qiyuan Tan, Ronghui Du, Liping Xie, Xiaodong Han, Hongwei Zhang, Yinfang Tu, Hong Zhang, Yuqian Bao, Haoyong Yu

Abstract readCase Reports
PubMed Full text at PMC Publisher
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Article in The American journal of case reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

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9 authors.

Qiyuan TanDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.ORCID 0009-0001-0098-7859
Ronghui DuDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Liping XieDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Xiaodong HanDepartment of General Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China.
Hongwei ZhangDepartment of General Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai, China.
Yinfang TuDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Hong ZhangDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Yuqian BaoDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
Haoyong YuDepartment of Endocrinology and Metabolism, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND Refeeding syndrome (RFS) and starvation-associated injuries are significant complications in malnourished patients. Severe weight loss after obesity surgery is frequently associated with malnutrition, consequently increasing the likelihood of RFS and starvation-related injuries as postoperative complications. RFS and starvation-induced injury in a single patient has rarely been reported. In this paper, we present, for the first time, a case of hepatic injury attributed to both refeeding syndrome and starvation-induced hepatic injury in a malnourished woman following bariatric surgery. CASE REPORT A 27-year-old female patient was admitted to the hospital for severe malnutrition after sleeve gastrectomy. Her body mass index (BMI) dropped from 37.2 kg/m² to 12.4 kg/m² 1 year after surgery. After nutritional supplementation, her liver enzymes levels increased significantly, with severe hypophosphatemia suggesting the development of RFS. During the calorie restriction treatment for RFS, the patient unexpectedly exhibited the recurrent increase of liver enzyme levels and severe reduction in body weight, albumin, and hemoglobin, which is considered to be caused by starvation-induced injury during the treatment of RFS. Following precise nutritional re-supplementation, her liver enzyme levels were dramatically decreased, with significant elevated hemoglobin and albumin levels at discharge and during the follow-up visit. CONCLUSIONS Chronic malnutrition and extreme weight loss can occur following bariatric surgery. Our report highlights the potential for RFS and starvation-related liver injuries as postoperative complications for high-risk patients after bariatric surgery. Liver injury can occur in both RFS and starvation-induced hepatitis. Nutrition initiation and supplementation should be carefully balanced in high-risk patients during nutritional treatments.

Indexed as

Bariatric SurgeryMalnutritionRefeeding SyndromeStarvationAdultFemaleHumansObesity, MorbidPostoperative Complications

Identifiers

PMID39397355
PMCPMC11489136

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