RESUMO
Obesity is a risk factor for the development of anterior abdominal wall hernias. Incisional hernias develop in up to 13% of laparotomies: the most difficult to repair are complex and multiple recurrent hernias with significant loss of control. The best approach to treating obese patients who concomitantly have hernias of the anterior abdominal wall is still a matter of debate. We present a clinical case of a patient with morbid obesity and abdominal hernia with loss of residence, who underwent bariatric surgery before ventral plasty.
La obesidad es un factor de riesgo para el desarrollo de hernias de la pared abdominal anterior. Las hernias incisionales se desarrollan hasta en el 13% de las laparotomías. Las más difíciles de reparar son las hernias recurrentes complejas y múltiples con pérdida significativa de domicilio. El mejor enfoque en el tratamiento de pacientes obesos y que concomitantemente tienen hernias de la pared abdominal anterior es aún un tema de debate. Presentamos el caso clínico de un paciente con obesidad mórbida y hernia abdominal con pérdida de domicilio, intervenido de cirugía bariatrica antes de la plastia ventral.
Assuntos
Cirurgia Bariátrica , Hérnia Abdominal , Hérnia Ventral , Obesidade Mórbida , Hérnia Abdominal/complicações , Hérnia Abdominal/cirurgia , Hérnia Ventral/cirurgia , Herniorrafia , Humanos , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Duração da Cirurgia , Telas CirúrgicasRESUMO
BACKGROUND: Common variants rs6232 and rs6235 in the PCSK1 gene have been associated with obesity in European populations. We aimed to evaluate the contribution of these variants to obesity and related traits in Mexican children and adults. METHODOLOGY/PRINCIPAL FINDINGS: Rs6232 and rs6235 were genotyped in 2382 individuals, 1206 children and 1176 adults. Minor allele frequencies were 0.78% for rs6232 and 19.99% for rs6235. Rs6232 was significantly associated with childhood obesity and adult class III obesity (ORâ=â3.01 95%CI 1.64-5.53; Pâ=â4 × 10â»4 in the combined analysis). In addition, this SNP was significantly associated with lower fasting glucose levels (Pâ=â0.01) and with increased insulin levels and HOMA-B (Pâ=â0.05 and 0.01, respectively) only in non-obese children. In contrast, rs6235 showed no significant association with obesity or with glucose homeostasis parameters in any group. CONCLUSION/SIGNIFICANCE: Although rs6232 is rare in the Mexican population, it should be considered as an important risk factor for extreme forms of obesity.