Abstract
Introduction: Obesity is defined as the abnormal or excessive accumulation of fat that can be harmful to health. It is estimated that about 10 million people are severely obese in Mexico. Gastric Sleeve (GS) is the main procedure performed worldwide and has shown excellent results in treating obesity. Materials and Methods: This is a retrospective study carried out by "Gastric Bypass Mexico" medical group from 2014 to 2016, where records of 1,030 patients who underwent a GS by 3 surgeons under the same technique were reviewed; Patients who were not approved by the multidisciplinary team were excluded. Results: A total of 1,032 surgeries were performed, 814 (79.03%) to women; the averages are: age - 35.01 years old; BMI 40.16Kg / m2 (30-90.56 kg / m2); intrahospital stay 1.11 (1-5) days; surgical time 20.01 (15-35) minutes, anesthetic time 37.50 (30-102) minutes. The mortality rate was 0% and the complications percentage was 3.20% (33): 20 (1.94%) patients had bleeding, of which 7 (35%) required a globular package transfusion (1-3 units); 10 (0.97%) patients had an infection in a surgical wound, 2 (0.19%) had gastropleural fistula and 1 (0.97%) patient had a gastric leak. Discussion: A GS is a safe and effective procedure for treating and controlling obesity. Compared to other techniques, a GS involves reduced anesthetic and surgical time, and offers short stays in the hospital. Conclusions: A GS offers excellent weight loss results, with a low morbidity and mortality rate.
Highlights
Moderate to large pericardial effusion secondary to hypothyroidy is well described in the literature
Most of the reported cases highlight the rarity of cardiac tamponade in the setting of hypothyroidy, which is generally associated with recurrent viral infections contributing to the progression towards tamponade [1]
The transthoracic echocardiogram was realized in all cases demonstrating clinically relevant pejorative signs and representing indications to emergency intervention; in particular, the presence of pericardial effusion of great abundance with compressive signs (Figure 2)
Summary
Moderate to large pericardial effusion secondary to hypothyroidy is well described in the literature. We discuss a series of three patients with pericardial tamponade associated to a hypothyroidy. Electrocardiogram (ECG) showed normal heart rate with low voltage pattern, electrical alternans were found in one patient (case 1). Two of the three cases presented flu-like symptoms a week prior to the hospitalization associated with the tamponade. All cases presented in a hypotensive state (without any signs of peripheric hypoperfusion) and symptoms of Figure 1: Chest radiogram showing cardiomegaly with globular enlargement. The transthoracic echocardiogram was realized in all cases demonstrating clinically relevant pejorative signs and representing indications to emergency intervention; in particular, the presence of pericardial effusion of great abundance with compressive signs (Figure 2). The 6-month follow-up exam was free of any signs with an echocardiogram negative for the presence of a recurrent pericardial effusion and a normalization of the TSH levels
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