The clinical manifestations of an inadvertent gastroileal anastomosis have been well delineated in several reviews based on the 84 cases reported in the literature.1-4 Although somewhat variable in presentation, the essence of the syndrome is the development of diarrhea, nonspecific or steatorrheal in character, shortly following a gastroenterostomy or gastric resection. At times, the clinical diagnosis of this entity may remain quite elusive despite suspicion of its presence. Even radiologic examinations may fail to demonstrate this surgically created intestinal bypass. This was true in 2 of our 3 cases and has been commented upon by others.1,5,6 The diagnostic value of a flat glucose tolerance test in this entity has been previously noted by this group in a consideration of the clinical and physiologic similarities between gastroileostomy and massive small bowel resection.7 This simple laboratory test warrants further emphasis, and we present 3 cases illustrating its usefulness.
COHEN BR, SCHAPIRA A, ADLERSBERG D. A Simple Clue to Gastroileostomy: Flat Glucose Tolerance Test. Arch Intern Med. 1962;109(6):660–664. doi:10.1001/archinte.1962.03620180022003
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