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Previous Volume 358:2813-2825 June 26, 2008 Number 26 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

Dr. Allyson K. Bloom (Medicine): A 57-year-old woman was admitted to this hospital because of abdominal pain and weakness. One month earlier, a laparoscopic Roux-en-Y gastric bypass and cholecystectomy were performed for treatment of obesity and gallstones. Pathological examination of a liver-biopsy specimen revealed nonalcoholic fatty liver disease. The immediate postoperative course was uncomplicated, and she was discharged 2 days after surgery. At follow-up visits, she reported poor oral intake, episodes of tachycardia (which had occurred intermittently in the past), intermittent passage of watery stool and dark urine, and suprapubic and epigastric pain; on two occasions, fluids were administered intravenously . . . [Full Text of this Article]

Differential Diagnosis

Abdominal Pain

Red Urine

Rapidly Progressive Weakness

Other Features of This Case

Acute Porphyria

            Diagnosis of Porphyria

            Classification of Porphyrias

            Causes of Attacks of Acute Porphyria

            Management of Attacks of Acute Porphyria

Clinical Diagnosis

Dr. Herbert L. Bonkovsky's Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Departments of Medicine and Molecular, Microbial, and Structural Biology, University of Connecticut Health Center, Farmington; the Department of Medicine, Carolinas Medical Center, Charlotte, NC, and University of North Carolina, Chapel Hill; and the Department of Biology, University of North Carolina, Charlotte (H.L.B.); and the Departments of Neurology (P.S.), Radiology (Z.R.), and Pathology (E.T.H-W., T.J.F.), Massachusetts General Hospital; and the Departments of Neurology (P.S.), Radiology (Z.R.), and Pathology (E.T.H-W., T.J.F.), Harvard Medical School — both in Boston.

This article has been cited by other articles:

• Bistrian, B. R., Baierlein, S. A., Wistop, A., Peters, T., Frankenburg, F. R., Kalivas, J., Pratt, J. S.A., Bonkovsky, H. L. (2008). Case 20-2008: Abdominal Pain and Weakness after Gastric Bypass Surgery. NEJM 359: 1850-1852 [Full Text]  
• (2008). Briefly Noted. Journal Watch Dermatology 2008: 2-2 [Full Text]