Obesity Surgery

, Volume 19, Issue 10, pp 1468–1470 | Cite as

When the Brakes Came Off: Re-feeding Oedema after Deflation of a Gastric Band: A Case Report

  • Royce P. Vincent
  • Simon J. B. Aylwin
  • Carel W. le Roux
Case Report


Bariatric surgery is now the treatment of choice for morbid obesity, but is not without risk. Patients are cared for in specialised centres, but complications can present to non-specialised centres. We describe life-threatening re-feeding oedema in a patient following routine deflation of a gastric band. Band deflation or removal may be required for various reasons, but rapid release of the band without additional supplementation of electrolytes may be dangerous due to re-feeding syndrome.


Bariatric surgery Gastric banding Re-feeding oedema 


Authors and contributors

Vincent RP:

I declare that I participated in the literature search, drafting of the paper, obtaining written consent from the patient and that I have seen and approved the final version.

Aylwin SJB:

I declare that I participated in drafting of the paper; critically reviewed its content and that I have seen and approved the final version.

le Roux CW:

I declare that I participated in drafting of the paper; critically reviewed its content and that I have seen and approved the final version.

Conflicts of interest



  1. 1.
    Smith FJ, Holman CD, Moorin RE, et al. Incidence of bariatric surgery and postoperative outcomes: a population-based analysis in Western Australia. Med J Aust. 2008;189:198–202.PubMedGoogle Scholar
  2. 2.
    Malinowski SS. Nutritional and metabolic complications of bariatric surgery. Am J Med Sci. 2006;331:219–25.CrossRefGoogle Scholar
  3. 3.
    Colossi FG, Casagrande DS, Chatkin R, et al. Need for multivitamin use in the postoperative period of gastric bypass. Obes Surg. 2008;18:187–91.CrossRefGoogle Scholar
  4. 4.
    Yang F, Fu D, Ni Q. Hyperinsulinemic hypoglycemia after bariatric surgery. Am J Gastroenterol. 2008;103:1047–8.CrossRefGoogle Scholar
  5. 5.
    Sjöström L, Narbro K, Sjöström CD, et al. Swedish obese subjects study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefGoogle Scholar
  6. 6.
    Dixon AF, Dixon JB, O'Brien PE. Laparoscopic adjustable gastric banding induces prolonged satiety: a randomized blind crossover study. J Clin Endocrinol Metab. 2005;90:813–9.CrossRefGoogle Scholar
  7. 7.
    Schnitker MA, Mattman PE, Bliss TL. A clinical study of malnutrition in Japanese prisoners of war. Ann Intern Med. 1951;35:69–96.CrossRefGoogle Scholar
  8. 8.
    Btaiche IF, Khalidi N. Metabolic complications of parenteral nutrition in adults, part 1. Am J Health Syst Pharm. 2004;61:1938–48.PubMedGoogle Scholar
  9. 9.
    Kalambokis GN, Tsatsoulis AA, Tsianos EV. The edematogenic properties of insulin. Am J Kidney Dis. 2004;44:575–90.CrossRefGoogle Scholar
  10. 10.
    Friedberg CE, van Buren M, Bijlsma JA, et al. Insulin increases sodium reabsorption in diluting segment in humans: evidence for indirect mediation through hypokalemia. Kidney Int. 1991;40:251–6.CrossRefGoogle Scholar
  11. 11.
    Tiwari S, Riazi S, Ecelbarger CA. Insulin's impact on renal sodium transport and blood pressure in health, obesity, and diabetes. Am J Physiol Renal Physiol. 2007;293:974–84.CrossRefGoogle Scholar
  12. 12.
    Spark RF, Arky RA, Boulter PR, et al. Renin, aldosterone and glucagon in the natriuresis of fasting. N Engl J Med. 1975;292:1335–40.CrossRefGoogle Scholar
  13. 13.
    Medndelshon ME, Karas RH. The protective effects of estrogen on the cardiovascular system. N Eng J Med. 1999;340:1801–11.CrossRefGoogle Scholar
  14. 14.
    Nesbakken R, Reinlie S. Magnesium and phosphorus: the electrolytes of energy metabolism. Acta Anaesthesiol Scand. 1985;29:60–4.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Royce P. Vincent
    • 1
  • Simon J. B. Aylwin
    • 2
  • Carel W. le Roux
    • 1
  1. 1.Department of Chemical PathologyKing’s College Hospital NHS Foundation TrustLondonUK
  2. 2.Department of EndocrinologyKing’s College Hospital NHS Foundation TrustLondonUK

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