The Effect of Revision of the Intestinal Bypass on Post Intestinal Bypass Arthritis

Spondyloarthropathy After Ampullary Carcinoma Resection

“…4,8,10 With rare exception, reanastomosis to reestablish bowel continuity has eliminated the syndrome. 9,10, [15][16][17] Although originally described after jejuno-iliac bypass, BADAS occurs more commonly after a jejuno-colic anastomosis 18 and has also been described in association with bilio-pancreatic diversion or bilio-intestinal bypass for morbid obesity, 19,20 Crohn disease, ileoanal pouch anastomosis, 21,22 ulcerative colitis, appendicitis, 23 diverticulitis, 11 and after Billroth II gastrectomy. 16,24 The standard surgical approach to carcinoma of the ampulla of Vater is the Whipple procedure, which involves en bloc resection of the gastric antrum and duodenum, a segment of the first portion of the jejunum, gallbladder, and distal common bile duct, the head and often the neck of the pancreas, and adjacent regional lymph nodes.…”

Maladies systémiques et vascularites

“…Dans les courts circuits intestinaux, d'authentiques polyarthrites et ténosynovites ont été rapportées [45,82,183,301,312] . Leur incidence varie de 6 à 52 % selon les séries .…”

Jejunoileal bypass as the main procedure in the onset of immune-related conditions: the model of BADAS

“…Knees, ankles, shoulders, wrists and metacarpophalangeal joints represent the sites most affected while axial skeleton involvement has been rarely described and tendonitis and myalgias have also been reported [62,63]. Articular symptoms are typically remittent and intermittent, and episodes can last for days to weeks followed by spontaneous resolution.…”

“…Although the treatment of BADAS consists of antibiotics such as tetracycline, metronidazole or clindamycin to overcome bacterial overgrowth, relief is generally only temporary. In this regard it may be useful to rotate antibiotics, in a dose of antibiotics for 1 week each month, or prokinetic agents such as cisapride that help to clear the small intestine [63,67]. NSAIDs may alleviate arthralgias and daily prednisone can control articular symptoms.…”

“…Bypass reversal is curative in the majority of patients partially responding to pharmacological therapy [63,68,69]. In patients without bowel bypass, treatment of the underlying GI disease has contributed to remission [8].…”