AB139. SOH21AS057. Laparoscopic gastric bypass for X-Tetrasomic patient: first time in Ireland

Background: Tetrasomy-X is a rare chromosomal disorder caused by the presence of four X chromosomes instead of two. It occurs only in females, as there are no Y chromosomes present. First described in 1961, only 100 cases have been reported worldwide since. We present a case of a young female with Tetrasomy-X, who underwent Gastric Bypass for obesity, first ever operation in medical literature for this disorder.

Methods: A 46-year-old morbidly obese patient with background of Tetrasomy-X was referred to our Metabolic Surgery Unit from Galway University Hospital in 2017. Since 2008 she attended multiple specialties and was involved in different weight loss programmes, with no improvement. Due to her comorbidities and genetic disorder related risk, surgery was never considered as an option. She was seen in our clinic with body mass index (BMI): 48 (148 kg) and symptomatic cholelithiasis. Laparoscopic Roux-en-Y Gastric Bypass and cholecystectomy was decided and performed on 11th March 2019.

Results: She made an excellent post-operative recovery and her quality of life has improved significantly. During first year follow up, she lost 38 kilograms and her BMI reduced to 33 (110 kg). Due to marked early weight loss, her comorbidities i.e. leg ulcers, metabolic syndrome improved as well.

Conclusions: Over the years, research has demonstrated that surgery is more efficient than non-surgical treatments for obesity. Bariatric surgery leads to greater weight loss, better remission of type 2 diabetes and greater improvements in quality of life. Our case, the first ever gastric bypass performed on a patient with Tetrasomy-X is unique in the bariatric literature and an excellent example to highlight the importance of urgent need for introduction of bariatric surgical programs. This is time to pay attention.

Keywords: Gastric bypass; Tetrasomy-X; bariatric surgery; obesity; weight loss