Micronutrient Deficiency and Protein-Calorie Malnutrition After Bariatric Surgery: Clinical Course and Outcome in Three Patients

The document reports on the clinical course and outcomes of three patients who experienced micronutrient deficiency and protein-calorie malnutrition after undergoing Roux-en-Y gastric bypass surgery and were non-adherent to routine follow-up. Case A involved a 60-year-old female who presented with weakness, chronic diarrhea, and skin eruptions consistent with zinc deficiency, among other symptoms. Despite receiving parenteral nutrition, she rapidly deteriorated and died from pneumonia with sepsis. Case B was a 46-year-old female with symptoms including weakness, syncope, and chronic diarrhea, diagnosed with kwashiorkor. She improved significantly with parenteral nutrition after oral supplementation proved inadequate. Case C, a 41-year-old female, presented with progressive vision loss, weakness, and numbness, and improved with total parenteral nutrition after deficiencies in copper, zinc, and vitamin B6 were identified. The cases emphasize the importance of regular monitoring and supplementation of micronutrients post-bariatric surgery to prevent severe complications and improve long-term outcomes.