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To the Editor.—
I have seen instances of encephalopathy following jejunoileostomy as reported by Ayub et al (1981;246:970) on a number of occasions. The symptoms are sometimes severe but are usually mild and transient, and they are often reported in retrospect. In February 1981, the following case clarified the problem for me.
Report of a Case.—
A 48-year-old man had a relatively successful jejunoileal bypass (JIB) seven years previously, experiencing satisfactory weight loss but also experiencing an episode of ureteral calculus, periodic episodes of bypass enteritis, continuing hypertension, and, more recently, several episodes of furunculosis and pustular dermatitis. The patient experienced light-headedness for two weeks and marked spatial disorientation for three days, to the extent that he was unable to walk without losing his balance. The diarrhea that the patient experienced had become more fluid, and he had five or six bowel movements a day. His symptoms varied in severity
Catlin R. Encephalopathy Following Jejunoileostomy. JAMA. 1982;247(23):3183–3184. doi:10.1001/jama.1982.03320480011007