Mistakes in... 2022 - 26

ueg education
Mistakes in... 2022
References
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Inflammed
pancreas
Dilated
and
ischemic
Alimentary
limb
Dilated
and
ischemic
2. Braghetto I, Csendes A. Prevalence of Barrett's
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3. Felsenreich DM, Kefurt R, Schermann M, et al. Reflux,
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4. Genco A, Soricelli E, Casella G, et al.
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5. Papadia FS, Marabotto E, Mascherini M, Rubartelli A,
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Obstruction
point
Common
limb
Figure 5 | Closed-loop obstruction of the
biliopancreatic limb after Roux-en-Y gastric
bypass.
varying severity is also frequently encountered.
This complication often occurs after derivative
or malabsorptive procedures and rarely after
restrictive gastric surgery.
Signs and symptoms of common vitamin
and mineral deficiencies comprise bone pain
(indicative of chronic vitamin D and calcium
deficiency, and regularly associated with
secondary hyperparathyroidism), anaemia (of
multifactorial origin), dermatologic signs like
eczema or brittle nails (zinc deficiency),
hemeralopia or night blindness (vitamin A
deficiency), and sensory-motor peripheral
neuropathy (vitamin E deficiency).
A mention is needed for vitamin B1 (thiamine)
deficiency. Diplopia or ophthalmoplegia after
vomiting (and prolonged vomiting) is an early
sign of Wernicke's encephalopathy due to
thiamine deficiency. It should be addressed
immediately to avoid permanent neurological
damage via parenteral (initially intravenous,
subsequently intramuscular) vitamin B1
administration. This sign is often overlooked.37,38
Supplementation with 100 mg/day of vitamin
B1 for patients with a clinical history of rapid and
substantial weight loss or vomiting is sufficient
to prevent Wernicke's encephalopathy. If clinical
suspicion of Wernicke's encephalopathy is already
present, intravenous treatment can be initiated
with 500 mg every 8 hours for 48 hours and
subsequently 250 mg for five days. Vitamin B1
supplementation should be continued in every
case, with intramuscular administration of 100
mg/day for three months.39
14
Biliopancreatic
limb
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13. Edholm D, Kullberg J, Haenni A, et al. Preoperative
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for the presurgical psychosocial evaluation of
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