May 1977

Bypass Enteritis or Obstructive Volvulus?

Author Affiliations

From the Department of Surgery, University of Louisville School of Medicine, and the University Surgical Service, Norton-Children's Hospital, Louisville, Ky.

Arch Surg. 1977;112(5):668. doi:10.1001/archsurg.1977.01370050128027

• In a consecutive series of 40 Scott-type jejunoileal shunts for morbid obesity, only two patients had the bypassed bowel drained end-to-side into the midsigmoid colon. In both of these patients, typical "bypass enteritis" as described by Passaro developed, but they were found to have volvulus at the sigmoid anastomosis. Both were cured by take-down of the anastomosis and reimplantation of the bypassed bowel into the transverse colon. No antibiotic treatment was found necessary. We suspect that obstruction of a mechanical nature plays a basic role in most, if not all, cases of "bypass enteritis."

(Arch Surg 112:668, 1977)