Case report of multidisciplinary approach to post single anastomosis sleeve jejunal bypass (SASJ) surgery refusal to eat

单吻合袖状空肠旁路术(SASJ)后拒食的多学科诊疗案例报告

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Abstract

INTRODUCTION AND IMPORTANCE: Bariatric surgeries are introduced as novel procedures in the whole world. Among the most important side effects after these surgeries is malnutrition. One of the reasons for suffocation can be the patient's psychological problems (such as depression). Paying attention to these symptoms can be effective in managing post-surgical complications. CASE PRESENTATION: A 36-year-old female patient who was operated with SASJ BYPASS surgery method presented three weeks after the surgery with symptoms of weakness, lethargy, nausea, vomiting, and PO (Per OS) intolerance, which did not respond to outpatient treatment. Barium swallow imaging and abdominopelvic CT scan was done for the patient and findings were normal. During conservative treatment and total parenteral nutrition (TPN) the patient underwent psychiatric consultation and took psychiatry medications. Gradually after these consultation sessions the patient had a good PO tolerance, no edema and no weakness and was discharged in a good condition. She was advised to continue psychologic consultation sessions besides other post-surgical follow ups. CLINICAL DISCUSSION: After complete assessment of malnutrion etiologies after bariatric surgeries it was advised to ensure that the patients demonstrate an understanding of the bariatric surgical procedure, necessity of changes in eating habits. Any existing psychological issues should be identified and treated the patient should be educated to make a commitment to multidisciplinary care after these surgeries. CONCLUSION: With continued communication, support, and multidisciplinary monitoring, nutritional complications can be minimized among patients undergoing bariatric surgeries. LEVEL OF EVIDENCE: V.

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