Refeeding syndrome: a fatal adverse event of gastric peroral endoscopic pyloromyotomy

Abstract

A 61-year-old woman with a history of chronic obstructive pulmonary disease and body mass index of 24 presented with recurrent hospital admissions for intractable nausea, vomiting, and weight loss of 40 pounds over the previous 3 months. The results of an extensive workup including upper and lower endoscopy, and CT of the chest, abdomen, and pelvis, were negative. A gastric emptying study demonstrated severe idiopathic gastroparesis. Medical treatment with metoclopramide (Reglan), erythromycin, and antiemetics was unsuccessful in controlling the symptoms.