Bilateral common peroneal neuropathy due to rapid and marked weight loss after biliary surgery: A case report

The causes of peroneal neuropathy are various, but are rarely due to weight loss. Bilateral peroneal neuropathy caused by weight loss after surgery has been reported only after bariatric surgery and there were no reports associated with other abdominal surgery. In this report, we describe a case of the bilateral peroneal neuropathy that occurred due to marked weight loss after biliary surgery. A 58-year-old male did not receive adequate nutritional support after biliary surgery, and showed a massive weight loss over a short period of time (body mass index; 24.1 kg/m to 20.5 kg/m for 24 d). Then, foot drop occurred on both sides. Physical examination, electromyography (EMG) and magnetic resonance imaging studies were conducted and he was diagnosed as bilateral common peroneal neuropathy around the fibular head level. The patient was treated electrical stimulation therapy on both lower legs along with exercise therapy, and received sufficient oral nutritional support. The patient gradually recovered to his original weight, and the power of the dorsiflexor of bilateral ankles improved after conservative treatment. In addition, the follow-up EMG showed signs of improvement. Any abdominal surgery that may have rapid and marked weight loss can lead to peroneal neuropathy as a complication.