A 21-year old woman, G1P0, was
admitted to our University Hospital at 33 weeks and 2 days of gestational age
with a 1 week history of nausea and vomiting. Two years before, in 2013, the
patient underwent laparoscopic adjusted gastric banding (LAGB) elsewhere for
morbid obesity with a BMI of 39.3. Postoperatively her BMI dropped to 23.5. The
medical history was limited to the LAGB.
Before transfer to our hospital, the
patient had already been admitted for 1 week in a general hospital. Because of
intractable vomiting, the band was loosened, without improvement of her
symptoms. Blood
sample showed doubled transaminases. Serology was negative for hepatitis A,
B and C virus, Epstein Barr virus and cytomegalovirus. Abdominal ultrasound
revealed distention of the stomach; the liver and biliary ducts were normal.
The abdominal ultrasound was repeated
after 3 days and revealed no new findings. Obstetric ultrasound there was
suspicion of intra-uterine growth restriction (IUGR) and anhydramnion. Finally
she was transferred to our hospital because of persistent vomiting, the
increased transaminases of unknown origin, and the suspected IUGR with anhydramnion.
No comments:
Post a Comment