Unilateral peroneal neuropathy in a patient following laparoscopic sleeve gastrectomy.

Postgraduate medicine Pub Date : 2024-09-01 Epub Date: 2024-09-04 DOI:10.1080/00325481.2024.2398413
Kwee-Yum Lee, Yaso Kathiravel, Sachin Khullar
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Abstract

Peroneal neuropathy, characterized by the occurrence of a foot drop, can develop due to a variety of factors, such as tumors, trauma, or metabolic conditions, making it one of the most prevalent peripheral neuropathies of the lower limbs. This condition is becoming more identifiable among patients who have undergone substantial weight reduction through bariatric surgery. The condition may present with symptoms like pain, sporadic paresthesia, and functional restrictions, primarily linked to foot drop. This case study explores an episode of acute foot drop in a patient who underwent a sleeve gastrectomy, leading to substantial weight loss.The patient, a middle-aged woman with a history of obesity, underwent sleeve gastrectomy and achieved normal body mass index (BMI) within a year. Eleven months post-surgery, she experienced a right-sided foot drop following a minor knee injury. Detailed history taking revealed noncompliance with vitamin supplementation, recurrent vomiting episodes, and a recent diagnosis of pancreatic insufficiency. Peripheral neuropathy, particularly peroneal nerve involvement, was confirmed through nerve conduction studies and radiological imaging. The mechanism of injury was attributed to rapid weight loss, potential nutrient deficiencies, and possible traction to the nerve.This case underscores the importance of early identification, comprehensive nutritional assessment, and timely intervention in managing neurological complications of post-bariatric surgery. Increased awareness among healthcare providers, particularly musculoskeletal specialists, is crucial as the prevalence of bariatric surgery continues to grow, ensuring optimal care for patients in this vulnerable population.

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一名腹腔镜袖带胃切除术患者的单侧腓总神经病变。
腓肠神经病变的特点是足下垂,可由多种因素引起,如肿瘤、外伤或代谢性疾病,是最常见的下肢周围神经病之一。在通过减肥手术大幅减轻体重的患者中,这种病症越来越容易被发现。该病可能表现为疼痛、零星麻痹和功能受限等症状,主要与足下垂有关。本病例研究探讨了一名接受袖状胃切除术后体重大幅下降的患者出现急性足下垂的情况。患者是一名有肥胖病史的中年女性,接受了袖状胃切除术,并在一年内达到了正常的体重指数(BMI)。手术后 11 个月,她在一次轻微膝伤后出现右侧足下垂。详细询问病史后发现,她没有按时补充维生素,反复呕吐,最近还被诊断为胰腺功能不全。通过神经传导研究和放射影像学检查,证实患者患有周围神经病变,尤其是腓肠神经受累。该病例强调了早期识别、全面营养评估和及时干预对控制减肥术后神经并发症的重要性。随着减肥手术的普及率不断提高,医疗服务提供者,尤其是肌肉骨骼专科医生,必须提高对这一问题的认识,以确保为这一弱势群体的患者提供最佳护理。
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