18 - Post-operative rhabdomyolysis

Summary

The increasing number of surgical patients with extreme obesity has increased the incidence of a postoperative complication that occurs more frequently in obese patients, rhabdomyolysis (RML). Rhabdomyolysis in morbidly obese (MO) patients is caused by tissue compression after extended periods of immobilization. Although history and physical examination can provide clues, the actual diagnosis of RML is confirmed by laboratory studies. The initial clinical expression of RML can be sudden, and an early diagnosis requires a high degree of suspicion. In a retrospective analysis, Grover et al. studied the lack of clinical utility of urine myoglobin detection by microconcentrator ultrafiltration in the diagnosis of RML. Both MRI and computed tomography (CT) are helpful in the diagnosis of RML. The treatment of RML is geared toward preserving renal function, by preventing factors that can lead to acute renal failure (ARF).