Francesca Lirosi

Intragastric Balloon Followed by Biliopancreatic Diversion in a Liver Transplant Recipient: A Case Report

Liver transplantation is a life-saving procedure for end-stage liver disease. In liver transplant recipients, morbid obesity influences post-operative survival and graft function. In 1996, our patient underwent a successful liver transplantation because of a HCV-related liver failure (body mass index (BMI) 31). Follow-up showed a functional graft and the development of severe obesity up to a BMI of 61 in January 2006. In January 2007, he was submitted to intragastric balloon therapy for 6 months, reaching a BMI of 54. In September 2007, he underwent a biliopancreatic diversion. During follow-up to March 2008, he reached a BMI of 42 with ameliorations of comorbidities. In May 2008, during a hospital admission, he suddenly died of a heart attack. Post mortem study revealed a myocardial infarction. This is the first world case report for this approach. According to our opinion, patient’s death was not related to bariatric surgery.

Palliation of proximal gastric cancer

of the splenic vein appear to predispose to PVT. In Dr Atweh and associates’ patient, underlying diseases including malignancy, coagulation disorder, and thrombocytosis were not detected. At present it should not be concluded that splenectomy itself leads to PVT, because more evidence is required. It is still a controversial issue. Prospective studies are needed to determine the incidence, diagnosis, and treatment of PVT for patients who undergo splenecetomy, as Dr Atweh comments. Considering previously mentioned symptoms and associated conditions like abnormal coagulation, cirrhosis, or trauma, careful followup after splenectomy using Doppler ultrasonography may play an important role in the early detection and appropriate treatment for PVT.