Postgastric Bypass Hypoglycaemia In A Patient With End-Stage Renal Disease: A Diagnostic And Management Pitfall

Keywords

Endocrinology; Gastroenterology; General practice / family medicine; Medical management; Pancreas and biliary tract

Abstract

Roux-en-Y gastric bypass (RYGB) surgery is currently one of the most popular procedures to aid weight loss. Hypoglycaemia associated with gastric bypass surgery is an underdiagnosed but life-threatening potential consequence of the surgical procedure. We present a case of a 44-year-old woman with end-stage renal disease presenting with refractory hypoglycaemia after 10 years of RYGB. Extensive history and work-up excluded medications, renal disease, insulinoma and dumping syndrome as the cause of hypoglycaemia. Dietary modifications or pharmacological trial of drugs did not ameliorate her symptoms with progressive worsening of hypoglycaemia leading to continuous dextrose infusion. Distal pancreatectomy was performed with subsequent resolution of hypoglycaemia. Surgical pathology results showed diffuse hyperplastic islet cells, confirming the diagnosis of postgastric bypass hypoglycaemia.

Publication Date

1-1-2017

Publication Title

BMJ Case Reports

Volume

2017

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1136/bcr-2017-220600

Socpus ID

85020887689 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/85020887689

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