Abstract：
Nutritional deficiencies and nonspecific gastrointestinal symptoms such as nausea, vomiting, and poor oral tolerance are commonly observed following bariatric surgery. When these symptoms persist, especially when accompanied by malnutrition and hypoalbuminemia, may indicate an underlying inflammatory process contributing to these conditions such as small intestine bacterial overgrowth (SIBO). This case study describes a 34-y-old pregnant woman with a history of bariatric surgery, who presented with generalized swelling, persistent nausea, bloating, steatorrhea, and was found to have severe malnutrition, 18 mo after biliopancreatic diversion with duodenal switch (BPS/DS). She was empirically treated for SIBO using systemic antibiotics and was started on parenteral nutrition to prevent further calorie deficit during pregnancy. This case underlines the complexity and challenges in diagnosing SIBO after bariatric surgery that includes the creation of Roux-en-Y anatomy, including BPS/DS, and the relationship between albumin, malnutrition, and the effect of systemic inflammation on the latter two.
摘要：
营养缺乏和非特异性胃肠道（GI）症状，如恶心，在减肥手术后通常观察到呕吐和口服耐受性差。当这些症状持续存在时，尤其是伴有营养不良和低蛋白血症时，可能表明导致这些病症的潜在炎症过程,例如小肠细菌过度生长(SIBO)。这个案例研究描述了一名34岁的孕妇，有减肥手术史，出现全身肿胀的人，持续性恶心,腹胀,脂肪泻,发现有严重的营养不良，术后18个月胆胰转流伴十二指肠开关(BPS/DS)。她使用全身性抗生素对SIBO进行了经验性治疗，并开始接受肠外营养治疗，以防止怀孕期间进一步的热量不足。此病例强调了在减肥手术后诊断SIBO的复杂性和挑战，包括创建Roux-en-Y解剖结构，包括BPS/DS，和白蛋白之间的关系，营养不良,以及全身性炎症对后两者的影响。
