Drenick E J, Roslyn J J
Medical and Research Service, Wadsworth VA Medical Center, Los Angeles, California 90073.
Dig Dis Sci. 1990 May;35(5):656-60. doi: 10.1007/BF01540416.
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.
为缓解病态肥胖而进行的空肠回肠旁路手术后出现的许多并发症是由被排除的盲袢内细菌过度生长引起的。关节炎-皮炎综合征是常见的令人痛苦的病症之一。其发病机制被认为是与旁路性肠炎相关的免疫复合物介导的过程。在大多数情况下，抗关节炎药物无效，皮肤病变难以治疗。一名45岁女性患有上述疾病。她还伴有腹泻、血细胞比容低、白细胞计数升高和血沉加快。她的营养状况良好，可能是由于功能短的小肠段适应性肥大。患者坚决拒绝拆除旁路或任何胃部限制手术。因此，切除了作为疾病根源的盲袢，所有不良影响立即得到缓解，实验室检查结果恢复正常。此后患者一直完全康复，体重保持稳定已有一年。
