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Intestinal bypass complications involving the excluded small bowel segment
The American Journal of Gastroenterology
|February 1, 1982
Summary
Bypass enteropathy affects 66% of patients with defunctionalized bowel after intestinal bypass surgery. Bacterial overgrowth in the bypassed segment causes most lesions, often diagnosed via X-ray or laparotomy.
Area of Science:
- Gastroenterology
- Surgical Complications
- Abdominal Radiology
Background:
- Intestinal bypass surgery can lead to complications in the defunctionalized bowel segment.
- Bypass enteropathy is a significant concern in patients who have undergone intestinal bypass.
Purpose of the Study:
- To examine the incidence and types of complications in the defunctionalized bowel of patients after intestinal bypass.
- To identify diagnostic findings and management strategies for bypass enteropathy.
Main Methods:
- Retrospective review of 119 intestinal bypass patients.
- Analysis of complications, including bypass enteropathy, pneumatosis cystoides intestinalis, bleeding, ulcerations, intussusception, and stenosis.
- Correlation of clinical presentation with diagnostic imaging (abdominal X-rays) and surgical findings.
Main Results:
- A 66% incidence of bypass enteropathy was observed.
- Common complications included bacterial overgrowth, ileal distention, and gas-fluid levels on X-rays.
- Specific issues like ulcerations, intussusception, and stenosis were identified, with some requiring laparotomy for diagnosis and treatment.
Conclusions:
- Bacterial overgrowth in the bypassed bowel is the primary cause of bypass enteropathy.
- Ileal distention and gas-fluid levels on X-rays are key diagnostic indicators.
- Management involves antibiotics (e.g., metronidazole) for inflammatory lesions and surgery for chronic or recurrent complications.