Digestive Diseases and Sciences

, Volume 35, Issue 5, pp 656–660 | Cite as

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

  • Ernst J. Drenick
  • Joel J. Roslyn
Case Report


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.

Key words

bypass enteritis arthritis-dermatitis syndrome curative resection blind loop 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sherman CD Jr, Faloon WW, Flood MS: Revision operations after bowel bypass for obesity. Am J Clin Nutr 30:98–102, 1977PubMedGoogle Scholar
  2. 2.
    Wands JR, LaMont JT, Mann E, Isselbacher KJ: Arthritis associated with intestinal-bypass procedure for morbid obesity. N Engl J Med 294:121–124, 1976PubMedGoogle Scholar
  3. 3.
    Utsinger PD: Systemic immune complex disease following intestinal bypass surgery: Bypass disease. Am Acad Dermatol 2:488–495, 1980Google Scholar
  4. 4.
    Bondar GF, Pisesky W: Complications of small intestinal short-circuiting for obesity. Arch Surg 94:707–716, 1967PubMedGoogle Scholar
  5. 5.
    O'Leary JP, Maher JW, Hollenbeck JI, Woodward ER: Pathogenesis of hepatic failure following jejunoileal bypass. Gastroenterology 66:859, 1974 (abstract)Google Scholar
  6. 6.
    Drenick EJ: Extraintestinal complications of jejunoileal bypass for obesity.In First United States Metronidazole Conference. SM Finegold, WL George, RD Rolfe (eds). New York, Biomedical Information Corporation, 1982, pp 371–382Google Scholar

Copyright information

© Plenum Publishing Corporation 1990

Authors and Affiliations

  • Ernst J. Drenick
    • 1
    • 2
  • Joel J. Roslyn
    • 1
    • 2
  1. 1.Medical and Research ServicesWadsworth VA Medical CenterUSA
  2. 2.Departments of Medicine and SurgeryUCLA School of MedicineLos Angeles

Personalised recommendations