Cure of arthritis-dermatitis syndrome due to intestinal bypass by resection of nonfunctional segment of blind loop. 1990

E J Drenick, and J J Roslyn
Medical and Research Service, Wadsworth VA Medical Center, Los Angeles, California 90073.

Many complications that followed jejunoileal bypass operations performed for the relief of morbid obesity were caused by bacterial overgrowth in the excluded blind loop. The arthritis-dermatitis syndrome was one of the common distressing disorders. The pathogenetic mechanism was thought to be an immune-complex-mediated process related to bypass enteritis. Antiarthritic medication was ineffective in most instances, and the skin lesions were refractory to treatment. A 45-year-old woman was suffering from the disorder as described above. She also had diarrhea, a low hematocrit, an elevated white blood cell count, and an increased sedimentation rate. Her nutritional status was satisfactory, presumably because of adaptive hypertrophy of the short functioning small intestinal segment. The patient adamantly refused dismantling of the bypass or any gastric restriction operations. Therefore, the blind loop, the source of her disease, was excised with immediate relief of all ill effects and restoration of normal laboratory findings. The patient has been entirely well since, and her weight has remained stable for one year.

UI MeSH Term Description Entries
D007581 Jejunoileal Bypass A procedure consisting of the SURGICAL ANASTOMOSIS of the proximal part of the JEJUNUM to the distal portion of the ILEUM, so as to bypass the nutrient-absorptive segment of the SMALL INTESTINE. Due to the severe malnutrition and life-threatening metabolic complications, this method is no longer used to treat MORBID OBESITY. Ileojejunal Bypass,Intestinal Bypass,Jejuno-Ileal Bypass,Bypass, Ileojejunal,Bypass, Intestinal,Bypass, Jejuno-Ileal,Bypass, Jejunoileal,Bypasses, Ileojejunal,Bypasses, Intestinal,Bypasses, Jejuno-Ileal,Bypasses, Jejunoileal,Ileojejunal Bypasses,Intestinal Bypasses,Jejuno Ileal Bypass,Jejuno-Ileal Bypasses,Jejunoileal Bypasses
D008795 Metronidazole A nitroimidazole used to treat AMEBIASIS; VAGINITIS; TRICHOMONAS INFECTIONS; GIARDIASIS; ANAEROBIC BACTERIA; and TREPONEMAL INFECTIONS. 2-Methyl-5-nitroimidazole-1-ethanol,Bayer 5360,Clont,Danizol,Flagyl,Gineflavir,Metric,MetroGel,Metrodzhil,Metrogyl,Metronidazole Hydrochloride,Metronidazole Monohydrochloride,Metronidazole Phosphate,Metronidazole Phosphoester,Satric,Trichazol,Trichopol,Trivazol,Vagilen,2 Methyl 5 nitroimidazole 1 ethanol
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D001765 Blind Loop Syndrome A malabsorption syndrome that is associated with a blind loop in the upper SMALL INTESTINE that is characterized by the lack of peristaltic movement, stasis of INTESTINAL CONTENTS, and the overgrowth of BACTERIA. Such bacterial overgrowth interferes with BILE SALTS action, FATTY ACIDS processing, MICROVILLI integrity, and the ABSORPTION of nutrients such as VITAMIN B12 and FOLIC ACID. Bacterial Overgrowth Syndrome,Stagnant Loop Syndrome,Loop Syndrome, Stagnant,Loop Syndromes, Stagnant,Stagnant Loop Syndromes,Syndrome, Bacterial Overgrowth,Syndrome, Blind Loop,Syndrome, Stagnant Loop,Syndromes, Stagnant Loop
D003872 Dermatitis Any inflammation of the skin. Dermatitides
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001168 Arthritis Acute or chronic inflammation of JOINTS. Oligoarthritis,Polyarthritis,Arthritides,Oligoarthritides,Polyarthritides

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