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18 - Post-operative rhabdomyolysis

from Section 4 - Post-operative conditions

Published online by Cambridge University Press:  04 May 2010

Adrian Alvarez
Affiliation:
Universidad de Buenos Aires, Argentina
Jay B. Brodsky
Affiliation:
Stanford University School of Medicine, California
Hendrikus J. M. Lemmens
Affiliation:
Stanford University School of Medicine, California
John M. Morton
Affiliation:
Stanford University School of Medicine, California
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Summary

The increasing number of surgical patients with extreme obesity has increased the incidence of a postoperative complication that occurs more frequently in obese patients, rhabdomyolysis (RML). Rhabdomyolysis in morbidly obese (MO) patients is caused by tissue compression after extended periods of immobilization. Although history and physical examination can provide clues, the actual diagnosis of RML is confirmed by laboratory studies. The initial clinical expression of RML can be sudden, and an early diagnosis requires a high degree of suspicion. In a retrospective analysis, Grover et al. studied the lack of clinical utility of urine myoglobin detection by microconcentrator ultrafiltration in the diagnosis of RML. Both MRI and computed tomography (CT) are helpful in the diagnosis of RML. The treatment of RML is geared toward preserving renal function, by preventing factors that can lead to acute renal failure (ARF).
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Chapter
Information
Morbid Obesity
Peri-operative Management
Publisher: Cambridge University Press
Print publication year: 2010

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