Psoriasis is a frequent skin disease, affecting 2% of the world's population. Stress, alcohol, smoking and obesity may be associated with psoriasis. A 56-year-old man with BMI 46.9 kg/m(2), hypertension and gastroesophageal reflux, had severe psoriasis for the last 39 years, without any remission on multiple treatments. Psoriatic papules and plaques were noted on his face, dorsum of hands, buttocks, knees, and elbows. He underwent open Roux-en-Y gastric bypass. At 4-month follow-up, the patient had lost 23 kg or 34.8% of excess weight, and presented complete remission of the psoriasis without medications. Bariatric surgery for positive metabolic, psychological and lifestyle consequences should be considered a treatment of psoriasis. Long-term observation is necessary.

Herpes zoster affects 10-20% of the general population. Motor complications sometimes occur in the segments corresponding to the involved sensory dermatomes causing abdominal wall pseudohernias. We present a case of a 57-year-old woman with herpes zoster characteristical rash following T11-T12 right dermatomes. Ten days after dermatologic manifestations onset, she had developed a protrusion at the abdominal wall on the right flank. The electroneuromyography confirmed axonal motor commitment, and morphological defects were ruled out by ultrasonography. The bulge totally disappeared after 4 months of observation. Postherpetic pseudohernia must be suspected when a patient develops signs and symptoms of motor dysfunction that coincide with or follow a herpes zoster eruption resulting in abdominal-wall herniation. A review of the literature concerning these extremely exceptional sequelae of herpes zoster is presented.

Gastrobronchial fistula (GBF) is a serious complication following bariatric surgery, whose treatment by thoracotomy and/or laparotomy involves a high morbidity rate. We present the outcomes of endoscopic management for GBF as a helpful technique for its healing process. This is a multicenter retrospective study of 15 patients who underwent gastric bypass (n = 10) and sleeve gastrectomy (n = 5) and presented GBF postoperatively (mean of 6.7 months). Ten patients developed lung abscess and were treated by antibiotic therapy (n = 10) and thoracotomy (n = 3). Abdominal reoperation was performed in nine patients for abscess drainage (n = 9) and/or ring removal (n = 4) and/or nutritional access (n = 6). The source of the GBF was at the angle of His (n = 14). Furthermore, 14 patients presented a narrowing of the gastric pouch treated by 20 or 30 mm aggressive balloon dilation (n = 11), stricturotomy or septoplasty (n = 10) and/or stent (n = 7). Fibrin glue was used in one patient. We performed, on average, 4.5 endoscopic sessions per patient. Endotherapy led to a 93.3% (14 out of 15) success rate in GBF closure with an average healing time of 4.4 months (range, 1-10 months), being shorter in the stent group (2.5 × 9.5 months). There was no recurrence during the average 27.3-month follow-up. A patient persisted with GBF, despite the fibrin glue application, and decided to discontinue it. GBF is a highly morbid complication, which usually arises late in the postoperative period. Endotherapy through different strategies is a highly effective therapeutic option and should be implemented early in order to shorten leakage healing time.

As RML is an important and potentially fatal complication of bariatric surgery, the best way to avoid it is effective prevention. More research on this subject is necessary.

Prophylactic measures and early diagnosis and treatment of rhabdomyolysis in bariatric surgery are imperative to prevent the potential fatal complications of this condition.