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Making the Connection (presentation (lifestyle (current smoker BI 1200,…
Making the Connection
presentation
41 yo M
159kg, BMI 49.1
bariatric surgery
morbidly obese since childhood
past history
hyperlipidemia
cholecystectomy
medication
rosuvastatin
ezetimibe
no drug allergies
family history
no known GI disorders
lifestyle
current smoker BI 1200
excessive alcohol history
abstinent for the 15 years
no illicit drug use
Time course
Roux-en-Y bypass
lost more than 80% of his weight
1 year later
83.9kg
weight gain
95.3kg
resume smoking
8 years later
pain in epigastric region and the left upper quadrant of the abdomen
5/10
exacerbated by eating
physical findings
(-)
guarding
rebound
(+)
abdominal tenderness
labo data
NP
computed tomography
inflammation of the gastrojejunal anastomosis
esophagogastroduodenoscopy
An ulceration on the jejunal side
omeprazole 40mg twice daily
Sucralfate 1g per 10ml
ulcer persistent for 6 months
began to have foulsmelling,
watery diarrhea six to seven times a day,
without nocturnal diarrhea.
4 m later
generalized weekness
myalgia
muscle cramps
95.3kg → 72.6 kg