SEARCH · PubMed Health

Results for “Blind Loop Syndrome”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources

PubMed1988

Surgical implications of jejunal diverticula.

To gain insight into the surgical significance of acquired jejunal diverticula, we reviewed the experience at the teaching hospitals in our city during the past ten years. An antemortem diagnosis of jejunal diverticulosis was made in 27 men and 59 women with a mean age of 69.6 years. In 71 patients the diagnosis was made during upper gastrointestinal roentgenologic evaluation for abdominal symptoms, in three it was made during mesenteric arteriography or bleeding scan for massive rectal bleeding, in six it was made during exploratory laparotomy for acute abdominal signs and symptoms, and in the remaining six it was an incidental intraoperative finding. Surgical indications occurred in 13 patients (15%) and consisted of massive lower gastrointestinal bleeding in four patients, blind loop syndrome in three, small bowel obstruction in three, diverticular perforation in two, and chronic abdominal pain requiring jejunal resection in one. In three additional patients with melena and nine with chronic abdominal pain, jejunal diverticulosis was the only abnormality detected; none of these patients had operation. Although the majority of patients with jejunal diverticula do not require surgical treatment, it may be necessitated by complications such as bleeding, perforation, obstruction, blind loop syndrome, or intractable abdominal pain.

Abdomen↗

PubMed1978

Effects of dihydroxy bile acids and hydroxy fatty acids on the absorption of oleic acid in the human jejunum.

Perfusion studies of the normal human jejunum were performed to test whether dihydroxy bile acids and hydroxy fatty acids inhibit the absorption of oleic acid, since previous reports documented their inhibitory effects on the absorption of several other organic solutes. 3 mM deoxycholate and 7 mM glycodeoxycholate inhibited the absorption of 3 mM oleic acid in isotonic micellar solutions while inducing net fluid secretion. Similarly, fractional absorption of oleic acid decreased in the presence of hydroxy fatty acids. However, only the changes induced by 2 mM ricinoleic acid could be distinguished from changes induced by an increase in total fatty acid concentration. Under all experimental conditions, close linear relationships existed between net water movement and fractional absorption of glucose, xylose, and fatty acids, as well as between the absorption rates of these solutes. In contrast, net fluid secretion induced by hypertonic D-mannitol (450 mosmol/liter) had no effect on solute absorption. Our data and observations in the literature do not allow formulation of a hypothesis which would adequately define all effects of dihydroxy bile acids and fatty acids on intestinal transport processes. The observations help explain the malabsorption of fat and other nutrients in patients with the blind loop syndrome.

Adult↗

PubMed1982

Malabsorption secondary to Meckel's diverticulum.

This case report of a patient with a large Meckel's diverticulum with associated stagnation and bacterial proliferation demonstrates the resultant metabolic and nutritional alterations that have classically been described with the blind loop syndrome. A lesion as large as the one presented herein has rarely been reported with iron, vitamin B12, and folic acid deficiency anemias secondary to the contaminated small bowel (ileum) syndrome. A discussion of the pathophysiology, diagnosis, and treatment of this disorder and the multiple disease entities incorporated in the contaminated small bowel syndrome are included.

Adult↗

PubMed1989

Multiple malignant lymphoma within an ileal blind loop--report of a case.

A 55-year-old woman presented to our hospital with abdominal fullness and edema of both legs. She had undergone a bypass operation by an ileotransversostomy for adhesive ileus following a drainage operation for acute appendicitis 35 years previously. We diagnosed the patient as having blind loop syndrome as a consequence of the side-to-side ileotransversostomy, and performed a right hemicolectomy and intestinal resection. The resected specimen of dilated ileal blind loop contained 15 crater-like lesions, proven histologically to be nodular proliferation of atypical lymphocytes. Lymph follicles had also proliferated in the mucosa of the blind loop and the histologically confirmed diagnosis of non-Hodgkins lymphoma of the diffuse medium-sized cell type was thus made. The etiology of such tumors is probably related to the alteration in intestinal environment caused by conditions such as fecal stasis, bacterial overgrowth, and bacterial toxins in the blind loop.

Blind Loop Syndrome↗

PubMed1981

Small intestinal bacterial overgrowth syndrome.

Explore the source record for details and available documents.

Blind Loop Syndrome↗

PubMed1978

Bacterial populations of the small intestine in uremia.

The small intestinal bacterial flora of 15 patients with chronic renal insufficiency was compared with that of subjects with blind loop synDROME. 9 patients were on regular hemodialysis with high protein intake and 6 (serum creatinine 7.5 to 12.5 mg/dl) were maintained on low protein diet. The chronic renal patients harbored a greatly increased microbial flora of both anaerobes and aerobes in the duodenum and jejunum, quantitatively comparable to those in blind loop subjects. The composition did not differ significantly in the two groups. Some organisms may have the potential to metabolize substrates which reach the intestinal lumen from the diet and bile, and perhaps to generate toxic metabolites that could contribute to uremic toxicity or malabsorption.

Aerobiosis↗

PubMed1979

Chronic pseudo-obstruction secondary to side-to-side intestinal anastomosis.

An unusual late complication of side-to-side intestinal anastomosis, chronic small-bowel obstruction with massive proximal ileal dilation despite a widely patent anastomosis, occurred in a patient. The classic blind loop syndrome was not present. Several potential mechanisms are suggested, including regional absence of normal peristalsis on a mechanical basis and bacterial overgrowth. This report adds support to the concept that side-to-side intestinal anastomosis should be avoided whenever possible.

Blind Loop Syndrome↗

PubMed1996

[Dementia caused by bacterial overgrowth in a patient with Billroth II gastrectomy].

We report the case of a patient in the Psychiatric Department who complained of progressive impairment of cerebral functions consistent with dementia, diarrhea and fecal incontinence in the last few months. His medical history included a Billroth II gastrectomy for gastric ulcer. Biochemical tests detected cobalamin deficiency, without megaloblastic anemia, and an abnormal Schilling test that was not due to intrinsic factor deficiency. Once other causes of cobalamin deficiency were ruled out, we considered it as a deficiency disease due to blind loop syndrome. Treatment with parenteral vitamin B complex and long term oral antibiotic therapy allowed the complete and permanent resolution of neurologic and digestive symptoms. We consider this case to be interesting because it shows the existence of curable dementias and the usefulness of taking into account bacterial overgrowth, usually underestimated, as an entity that can produce a variety of disorders.

Administration, Oral↗

PubMed1976

Amine metabolism and the small bowel in uraemia.

Intestinal intubation was carried out in 21 subjects: 9 with end-stage renal failure, 2 with early renal insufficiency, 7 untreated patients with blind-loop syndrome, and 3 normal volunteers. All 9 patients with uraemia had significantly raised duodenal dimethylamine (D.M.A.) concentrations compared with the other groups tested. Alteration of the intestinal bacterial flora with antibiotics markedly reduced serum D.M.A. and trimethylamine concentrations and modified the symptoms. Potentially toxic metabolites in the small bowel might have significant nutritional and toxic sequelae in uraemia and these findings suggest that current therapeutic approaches to the treatment of end-stage kidney disease should be re-examined in relation to bowel flora.

Anti-Bacterial Agents↗

PubMed1993

[Blind loop of the large intestine--bypass enteropathy or diversion colitis?].

Investigating three patients with longstanding diarrhoea, severe abdominal bloating and cramps revealed an exclusion of the right hemicolon in all patients and additionally of the terminal ileum in one of them. The anastomosis of the ileo-colic bypass, performed decades ago due to complicated appendicitis, was stenotic in two of them. Because a classical blind-loop-syndrome could not be proven, the functional disorder is described as a clinical entity characterized by signs of bypass-enteropathy and diversion-colitis. The importance of the radiological examination for diagnosis and therapy-planing is emphasized, because endoscopically and histologically Crohn's disease might be suspected. The surgical reintegration of the bowel into the orthograde continuity of the intestinal tract is recommended as the causative treatment. Symptoms disappear completely and patients win normal health even after some decades, because the morphological signs of inflammation are reversible and bowel function is not lost during the exclusion.

Adult↗

PubMed1976

[Adaptive changes in intestinal mucosa of the small intestine as a result of intraluminal stress].

Under physiological conditions, the intestinal mucosa is the site of a delicate balance between cell proliferation in the crypt region and cell desquamation at the villus tips. This balance can be deranged by a number of endogenous or exogenous factors, oneof which is the intraluminal contents. This review discusses the effects of different modifications of the luminal milieu on the structure and function of the mucosa. Following intestinal resection or loop transposition, the contents reaching the remnant or the transposed loop differ markedly from those with which they come into contact under normal conditions. Hyperplasia without zonal transformation then develops in the experimental loop. The villi do not become wider, and changes in the strucutre of the epithelium are not observed. There are conflicting resutls in the literature concerning the enzyme activities in the individual enterocytes resulting from this hyperplasia. However, the epithelium its functionally immature, since transport capacities measured in vitro are reduced. On the other hand, the hyperplasia of the mucosa is such that absorptive capacities in vivo, when expressed in terms of intestinal length, are larger than normal. When the intestine is subjected to prolonged infusion of lactic acid, the enterocytes are damaged and increased exfoliation results. A similar result is obtained in the blind-loop syndrome, where the accumulation of bile acids and bacteria provides the stress responsible for the destruction of the enterocytes, and in non-tropical spure, where the epithelium is attacked by noxious peptides in the diet. The first consequence of the accelerated desquamation is epithelial hyperplasia without zonal transformation, though the enterocytes are damaged - in contrast to those of the resected intestine - and apparently possess reduced enzyme activities. If the application of the stress is continued, a stage is reached in which the cell proliferation does not suffice to counteract the cell loss at the villus tips. Then a zonal transformation occurs whereby, despite the lengthened crypts, the villi become shorter and wider until, in extreme cases, the mucosa is completely devoid of villi. The transport capacity in vitro and in vivo - even when expressed in terms of unit-length is reduced, and good correlations exist between the reduction in function and the diminution in surface area of the intestine. In a self-emptying blind loop, the intestine is devoid of all contact with nutritional material. Under these circumstances, hypoplasia of the mucosa develops in which the enterocytes appear unchanged, though in extreme cases they may possess reduced enzyme levels, and the absorption capacity in vivo is consequently reduced.

Adaptation, Physiological↗

PubMed1976

Unusual anomaly of the small intestine with malabsorption.

Malabsorption as a complication of anatomic congenital anomalies of the small bowel is uncommon. In this case, malabsorption syndrome in infancy, with features suggestive of coexisting disaccharide intolerance and blind loop syndrome, was the major clinical presentation of a combined anomaly, consisting of a large saccular dilation of the ileum containing heterotropic gastric mucosa, and an adjacent small intramesentric cyst partially lined by small bowel epithelium. Prompt reversal of metabolic and nutritional abnormalities followed surgical resection.

Disaccharides↗

PubMed1991

Jejunoileal Bypass Operations With a Side-to-side Anastomosis in the Treatment of Morbid Obesity.

In order to avoid a stagnant loop syndrome in intestinal bypass operations for morbid obesity, we have tried a jejunoileal bypass with a side-to-side anastomosis in a pilot study. Seven patients were operated on with this method, which resulted in a very high incidence of liver damage. The study puts a question mark to the blind loop syndrome as an etiological factor in producing liver damage.

Journal Article↗

PubMed1983

Technical complications of Roux-en-Y gastrojejunostomy.

The Roux-en-Y gastrojejunostomy has become an increasingly popular technique for gastrointestinal tract reconstruction since it is purported to obviate many of the classic complications of the Billroth II gastrojejunostomy. In a review of over 900 Roux-en-Y gastrojejunostomies, seven patients with complications mimicking those seen with Billroth II reconstruction were identified. These complications included duodenal stump blowout, proximal blind loop or afferent loop syndrome, and bile-reflux gastritis. These complications resulted from technical problems in construction of the Roux-en-Y. Once the complications were diagnosed, they were amenable to operative correction. Recognition of the potential for these complications following Roux-en-Y gastrojejunostomy should aid in early diagnosis and treatment.

Adult↗

PubMed1984

[Endoscopic exploration of the small intestine].

The development of Japanese enteroscopes, mot of which are still prototypes, has made it possible to explore the entire small bowel. These instruments are either introduced into the jejunum like an ordinary endoscope, or pushed along a guidewire, or weighted with mercury, like a Miller-Abbott probe. A simplified study of the adult malabsorption syndrome can be performed by proximal jejunoscopy, usually carried out in Europe with a paediatric colonoscope. Perendoscopic forceps biopsy of the jejunum can replace probe sampling and is well suited to measurements of disaccharidase activity. In cases with "blind loop syndrome", bacteriological examination of the intestinal juice, endoscopically collected in sterile conditions, usefully supplements the visual and bioptic information. Since several investigations can be performed during one single enteroscopic examination, this method will be increasingly used in the study of small bowel diseases.

Biopsy↗

PubMed1992

[The surgical treatment of the short bowel syndrome by creating reservoir pouches. An experimental study on rats].

Intestinal pouches are one of the techniques for the surgical treatment of the short bowel syndrome. In a experimental study with rats, the influence of the intestinal pouches in a model of 85-90% small bowel resection are investigated. The pouches improve the transit time of the resected animal. However, there is no improvement in the weight curves after extensive small bowel resection. This negative effect is due to the establishment of a blind loop syndrome at the level of the pouch. The intestinal pouches have no place in the surgical treatment of the short bowel syndrome.

Anastomosis, Surgical↗

PubMed1990

Complications associated with surgical treatment of congenital intrinsic duodenal obstruction.

Although survival rates for infants undergoing surgical treatment for congenital intrinsic duodenal obstruction are high, long-term follow-up suggests a high complication rate related to surgical therapy. We reviewed 33 neonates who underwent surgery for congenital intrinsic duodenal obstruction during the past 10 years. There were 20 girls and 13 boys; the mean gestational age was 36 weeks, and mean birthweight was 2,485 g. Bilious vomiting and intestinal obstruction were the most frequent presenting symptoms. Hydramnios was present in 75% of cases and 21% had associated Down's syndrome. Findings at laparotomy included duodenal atresia (14), annular pancreas (11), and duodenal diaphragm (8). The most frequent surgical procedure was side-to-side duodenoduodenostomy (DD), followed by duodenojejunostomy and resection of web with Heineke-Mikulicz type duodenoplasty. Bowel transit was reestablished at a mean of 13.1 days (range, 6 to 45 days). Seventy-percent of patients developed postoperative complications, the most frequent being megaduodenum with blind loop syndrome or bile reflux gastritis (22%), cholestatic jaundice (17%), gastroesophageal reflux (17%), delayed transit (8%), and bowel obstruction (8%). Six patients (18%) required secondary surgical procedures for postoperative complications (ie, megaduodenum, nonfunctioning anastomosis, missed intrinsic stenosis). Two patients died (6%). Stagnation and functional obstruction in the proximal duodenum is the main factor influencing the morbidity rate among these patients. Consideration should be given to the tapering duodenoplasty and diamond-shaped anastomosis in order to help reduce problems associated with megaduodenum and help restore earlier bowel transit.

Abnormalities, Multiple↗

PubMed1998

[Malnutrition in a patient with short-bowel syndrome].

The short bowel syndrome is a relatively frequent complication of extensive resection and by reducing the absorption capacity the function of the gut is markedly impaired. An important part of postoperative care is therefore to ensure nutrition of these patients. The authors demonstrate on the case-history of a 40-year-old patient after repeated revision of the abdominal cavity on account of adhesions the development of severe malnutrition after jejunotransversoanastomosis. As the small intestine was not resected (concurrent blind loop syndrome), the patient was indicated for surgery. After surgery all complaints disappeared and the nutritional status improved.

Adult↗