The Unexpected Evolution of an Expected Complication: Hemophagocytic Lymphohistiocytosis

Excerpt

Severe obesity is associated with consistent morbidity and mortality. Bariatric surgery is presently the most effective treatment for this condition [1, 2], and laparoscopic Roux-en-Y gastric bypass (RYGB) is the most common surgical procedure performed [1]. RYGB carries a mortality risk of 0.5–1.9% [2]. One feared early surgical complications is postoperative leak, occurring in 2.1–5.2% of patients and having a mortality rate up to 50% [3, 4]. Hemophagocytic lymphohistiocytosis (HLH) is a rare disease, characterized by an uncontrolled inflammatory response that leads to systemic compromise and in the end to death by multi-organ failure, bleeding, sepsis, or disseminated intravascular coagulation (DIC) [5]. We report the first case of HLH associated with complicated bariatric surgery, investigating possible reasons for this association. …