Rapid Communication| Volume 43, ISSUE 7, e27-e30, July 2008

Preserved vision without growth retardation after laparoscopic Roux-en-Y gastric bypass in a morbidly obese child with pseudotumor cerebri: 36-month follow-up


      A 12-year-old boy presented with a weight of 136 kg and a history of progressive vision loss associated with unremitting pseudotumor cerebri requiring bilateral optic nerve sheath decompression. He underwent laparoscopic Roux-en-Y gastric bypass (RYGBP) without complication. At 36 months post-RYGBP, he has grown 5 cm since the time of surgery, his weight is 6.8 kg above his postoperative nadir weight of 68.2 kg, and his visual acuity has improved with OD 20/100 (preoperative, 20/200) and OS 20/70 (preoperative, 20/100). This case suggests that RYGBP can be performed safely and without stopping linear growth in carefully selected children.

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        • Hedley A.A.
        • Ogden C.L.
        • Johnson C.L.
        • et al.
        Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002.
        JAMA. 2004; 291: 2847-2850
        • Strauss R.S.
        • Pollack H.A.
        Epidemic increase in childhood overweight, 1986-1998.
        JAMA. 2001; 286: 2845-2848
        • Whitaker R.C.
        • Wright J.A.
        • Pepe M.S.
        • et al.
        Predicting obesity in young adulthood from childhood and parental obesity.
        N Engl J Med. 1997; 337: 869-873
        • Freedman D.S.
        • Mei Z.
        • Srinivasan S.R.
        • et al.
        Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study.
        J Pediatr. 2007; 150: 12.e2-17.e2
        • Sinha R.
        • Fisch G.
        • Teague B.
        • et al.
        Prevalence of impaired glucose tolerance among children and adolescents with marked obesity.
        N Engl J Med. 2002; 346: 802-810
        • Dietz W.H.
        Health consequences of obesity in youth: childhood predictors of adult disease.
        Pediatrics. 1998; 101: 518-525
        • Sugerman H.J.
        • Felton III, W.L.
        • Sismanis A.
        • et al.
        Gastric surgery for pseudotumor cerebri associated with severe obesity.
        Ann Surg. 1999; 229 ([discussion 40-2]): 634-640
        • Sugerman H.J.
        • Felton III, W.L.
        • Salvant Jr, J.B.
        • et al.
        Effects of surgically induced weight loss on idiopathic intracranial hypertension in morbid obesity.
        Neurology. 1995; 45: 1655-1659
        • Schauer P.R.
        • Ikramuddin S.
        • Gourash W.F.
        Laparoscopic Roux-en-Y gastric bypass: a case report at one-year follow-up.
        J Laparoendosc Adv Surg Tech A. 1999; 9: 101-106
        • Inge T.H.
        • Garcia V.
        • Daniels S.
        • et al.
        A multidisciplinary approach to the adolescent bariatric surgical patient.
        J Pediatr Surg. 2004; 39 ([discussion 6-7]): 442-447
        • Sugerman H.J.
        • Felton III, I.W.
        • Sismanis A.
        • et al.
        Continuous negative abdominal pressure device to treat pseudotumor cerebri.
        Int J Obes Relat Metab Disord. 2001; 25: 486-490
        • Sugerman H.J.
        • Sugerman E.L.
        • DeMaria E.J.
        • et al.
        Bariatric surgery for severely obese adolescents.
        J Gastrointest Surg. 2003; 7 ([discussion 7-8]): 102-107
        • NIH conference
        Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel.
        Ann Intern Med. 1991; 115: 956-961
        • Mason E.E.
        • Scott D.H.
        • Doherty C.
        • et al.
        Vertical banded gastroplasty in the severely obese under age twenty-one.
        Obes Surg. 1995; 5: 23-33
        • Lawson M.L.
        • Kirk S.
        • Mitchell T.
        • et al.
        One-year outcomes of Roux-en-Y gastric bypass for morbidly obese adolescents: a multicenter study from the Pediatric Bariatric Study Group.
        J Pediatr Surg. 2006; 41 ([discussion -43]): 137-143
        • Nadler E.P.
        • Youn H.A.
        • Ren C.J.
        • et al.
        An update on 73 US obese pediatric patients treated with laparoscopic adjustable gastric banding: comorbidity resolution and compliance data.
        J Pediatr Surg. 2008; 43: 141-146
        • de Jong M.D.
        • Bach V.C.
        • Phan T.Q.
        • et al.
        Fatal avian influenza A (H5N1) in a child presenting with diarrhea followed by coma.
        N Engl J Med. 2005; 352: 686-691
        • Holterman A.X.
        • Browne A.
        • Dillard III, B.E.
        • et al.
        Short-term outcome in the first 10 morbidly obese adolescent patients in the FDA-approved trial for laparoscopic adjustable gastric banding.
        J Pediatr Gastroenterol Nutr. 2007; 45: 465-473
        • Dillard III, B.E.
        • Gorodner V.
        • Galvani C.
        • et al.
        Initial experience with the adjustable gastric band in morbidly obese US adolescents and recommendations for further investigation.
        J Pediatr Gastroenterol Nutr. 2007; 45: 240-246
        • Al-Qahtani A.R.
        Laparoscopic adjustable gastric banding in adolescent: safety and efficacy.
        J Pediatr Surg. 2007; 42: 894-897
        • Stanford A.
        • Glascock J.M.
        • Eid G.M.
        • et al.
        Laparoscopic Roux-en-Y gastric bypass in morbidly obese adolescents.
        J Pediatr Surg. 2003; 38: 430-433