Weight reduction after bariatric surgery - Do results correlate with postoperative visit frequency?

Background: Consistent follow up after a bariatric surgery is considered vital to adequate and sustained weight reduction. This study examined the strength to which compliance with postsurgical appointments predicted an increase in total body weight loss percent (TBWL%) and change in body mass index (BMI) in a cohort of Illinois based surgical center patients. Methods: Participants (n = 78) were patients with obesity who underwent bariatric surgery between 2019 and 2021. Patient preoperative weight and BMI, and postoperative weight and BMI at 3-month intervals for one year, and the number of visits were collected from chart review to calculate TBWL%, and change in BMI. Relationship between these factors and postoperative visit compliance were evaluated using linear regression to assess if it was a significant predictor of success. Results: Follow up visit compliance had a weak positive association with increased TBWL% (Model R2 = 0.134, B = 0.011, p = 0.004) and a minimally stronger association with increased change in BMI (Model R2 = 0.229, B = 0.015, p = 0.0001). Conclusions: Adherence with follow up visits was weakly related to improved weight reduction outcomes after bariatric surgery. Future investigations should consider how follow up visits can better influence a patient's success in sustaining achieved weight reduction.

Non-strangulated Spigelian Hernia: A Case Report.

Spigelian hernia is a rare type of ventral hernia with an incidence of 0.1-2%. We report a case of a non-strangulated left lower quadrant spigelian hernia and its management. A 74-year-old female presented with progressively worsening left flank pain along with dysuria and frequency related to pyelonephritis. Incidentally, CT of the abdomen and pelvis demonstrated a left spigelian hernia containing intermediate size small bowel without strangulation. Thereafter, she began developing increasing abdominal pain in that area. The hernia was repaired on the same day as admission via laparoscopic intraperitoneal onlay mesh-plus repair. Spigelian hernia possesses an elusive clinical presentation. Though rare, it must be considered in the differential diagnosis of abdominal hernia due to its high risk for acute complications.

Pneumatosis Intestinalis, Pneumoperitoneum, and Ascites Secondary to Scleroderma: A Case Report.

Pneumatosis intestinalis (PI), pneumoperitoneum, and ascites are radiographic findings that may be incidental or associated with severe bowel compromise. Asymptomatic patients with benign PI, pneumoperitoneum, or ascites are often observed or treated conservatively. However, these findings are concerning in symptomatic patients and often require surgical consultation and urgent surgical intervention Approximately 15% of PI cases are idiopathic, and 85% are secondary due to an underlying pathology including but not limited to pulmonary disease, autoimmune disease, drug-induced sources, gastrointestinal disease, infectious sources, and iatrogenic sources. A management plan for PI proves challenging to create when the pathogenesis is poorly understood and the presenting clinical picture varies. Reported is a case of a 51-year-old female with severe abdominal pain, PI, pneumoperitoneum, and ascites. Managing a patient presenting this way with surgical intervention is a viable option; however, this patient's management was successful using a conservative approach.