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Rhabdomyolysis: Diagnosis and Treatment in Bariatric Surgery
Authors:João E. M. T. M. Ettinger MD  Carlos A. Marcílio de Souza MD   PhD  Paulo V. Santos-Filho  Euler Azaro MD   PhD  Carlos A. B. Mello MD  Edvaldo Fahel MD   PhD  Paulo B. P. Batista MD   PhD
Affiliation:1. Postgraduate Course of Medicine and Human Health, Escola Bahiana de Medicina, Bahia, Brazil
2. Bariatric Surgery Division, Department of Surgery, Hospital S?o Rafael (HSR) and Hospital Cidade, Bahia, Brazil
3. Nephrology Division HSR, Salvador, Bahia, Brazil
Abstract:Background Rhabdomyolysis (RML) and subsequent acute renal failure can be serious problems following bariatric operations. Early diagnosis and treatment are important to avoid the complications of RML. Methods This review was achieved by searching the key words: Rhabdomyolysis, diagnosis, treatment and bariatric surgery.We included prospective, retrospective, case reports and review articles. Results RML diagnosis can be done by: signs and symptoms, physical evaluation, laboratory findings and imaging examinations. Muscle weakness, myalgia, decubitus ulcer, proteinuria and myoglobinuria are the more mentioned findings. Elevation of CPK levels is the most sensitive diagnostic evidence of RML. Treatment is geared toward preserving renal function by avoiding dehydration, hypovolemia, tubular obstruction, aciduria, and free radical release. Early recognition allows the administration of fluids, bicarbonate, and mannitol. Conclusion Prophylactic measures and early diagnosis and treatment of rhabdomyolysis in bariatric surgery are imperative to prevent the potential fatal complications of this condition.
Keywords:Rhabdomyolysis  bariatric surgery  diagnosis  treatment  morbid obesity  acute renal failure  CPK
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