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Rheumatology 2001; 40: 351-353
© 2001 British Society for Rheumatology

Letters to the Editor

First presentation of intestinal bypass syndrome 18 yr after initial surgery

C. Fisch, P. Schiller, T. Harr and D. Maclachlan1

University Department of Dermatology, Kantonsspital Basel, Petersgraben 4–6, 4031 Basel and
1 University Department of Rheumatology, Felix-Platter-Spital, Burgfelder Strasse 101, 4055 Basel, Switzerland

The first 10% of the full text of this article appears below.

SIR, From the 1950s to the 1980s, intestinal bypass operations were used to reduce weight in morbidly obese patients [1]. Loss of weight was often successful but bacterial overgrowth of the blind loop caused secondary, extraintestinal complications such as arthritis and vasculitis. The so-called intestinal bypass syndrome affected about 20% of the surgically treated patients [2]. We describe a patient with therapy-refractory oligoarthritis and necrotizing cutaneous vasculitis that appeared for the first time 18 yr after an intestinal bypass operation.

The patient, a 40 yr old male weighing 140 kg, with a history of a jejuno-ileostomy in 1979 for morbid obesity and no other history of note, developed arthritis . . . [Full Text of this Article]


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