Obesity Surgery

, Volume 19, Issue 8, pp 1176–1179

Brown Bowel Syndrome Secondary to Jejunoileal Bypass: The First Case Report

  • Hwajeong Lee
  • Arthur M. Carlin
  • Adrian H. Ormsby
  • Min W. Lee
Case Report

Abstract

A 58-year-old woman with a surgical history of jejunoileal bypass in 1980 for weight reduction sought medical attention with multiple complaints. The patient had not been taking any nutritional supplements since her bypass surgery, 26 years previously. She was found to have osteomalacia, chronic diarrhea, secondary hyperparathyroidism, and hyperoxaluria with a frequent history of nephrolithiasis. Because of her severe osteodystrophy and metabolic complications, reversal of her jejunoileal bypass was recommended. Reversal of the jejunoileal bypass with a sleeve gastrectomy was performed. Laparotomy revealed brown discoloration of the entire alimentary limb with atrophy of the bypassed intestinal limb. Histologic examination of the resected small bowel demonstrated brown pigment deposits within smooth muscle cells of the bowel wall. The pigment stained positive with Fontana-Masson most likely representing lipofuscin. We report a case of brown bowel syndrome complicating jejunoileal bypass, the first case reported in the literature to the best of our knowledge.

Keywords

Bariatric surgery Malnutrition Jejunoileal bypass Brown bowel syndrome Lipofuscin 

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Hwajeong Lee
    • 1
  • Arthur M. Carlin
    • 2
  • Adrian H. Ormsby
    • 1
  • Min W. Lee
    • 1
  1. 1.Department of Pathology and Laboratory MedicineHenry Ford HospitalDetroitUSA
  2. 2.Department of SurgeryHenry Ford HospitalDetroitUSA

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