Liver-Failure-after-Bariatric-Surgery-Clinical-Case-and-Literature-Review

Abstract

The public health problem of obesity has led to a growing number of bariatric surgeries. Despite its efficacy and metabolic benefits, bariatric surgery has several complications, metabolic liver disease being one of them. Although most of the patients only experience mild to moderate disease, cases of severe steatohepatitis and progression to cirrhosis have been reported. We present the case of a 49-year-old, morbidly obese woman who underwent a bariatric surgery (bilio-pancreatic diversion). After the procedure, she developed profuse diarrhea, persistent vomiting leading to drastic weight loss and liver failure. Liver biopsy showed steatohepatitis and fibrosis. Liver transplantation was considered but the patient improved under medical therapy in ICU. Ultimately, nosocomial infection led to septic shock and death. Awareness of these possible bariatric surgery complications is important for its prevention, diagnosis and eventual liver transplant indication.