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A Brief History of Nutritional Medicine and the Emergence of Nutrition as a Medical Subspecialty
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Bariatric surgery dates back to the 1950s with the development of effective procedures such as various forms of the jejunoileostomy or JI bypass (JIB) (Kremen, Linner, and Nelson 1954). Unfortunately, this procedure was fraught with medical risks including severe vitamin deficiencies and blind loop syndrome. Hepatic dysfunction and even liver failure occurred, resulting in the procedure’s discontinuation (Griffen, Bivens, and Bell 1983). This was followed by the development of the roux-en-Y gastric bypass (RYGB) by Edward E. Mason in 1966 (Mason and Ito 1967) and the biliopancreatic diversion (BPD) by Nicola Scopinaro et al. in 1979 (Scopinaro et al. 1979).
Gastrointestinal surgery in gynecologic oncology
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Eileen M. Segreti, Stephanie Munns, Charles M. Levenback
Alternatively, the bowel is divided proximally and distally to the damaged segment, and the damaged bowel is completely excluded from the intestinal stream. One end of the bypassed limb is brought up to the skin as a mucous fistula. A third option is to divide the bowel proximal to the damaged area and create an anastomosis distally. The mucous fistula may be incorporated into the inferior aspect of the incision. A disadvantage of bowel bypass is that it may subsequently foster a blind-loop syndrome. The blind-loop syndrome is characterized by bacterial overgrowth with subsequent cramps, diarrhea, anemia, and weight loss (Schlegel and Maglinte 1982). If a small bowel fistula is being bypassed, it is important to completely isolate this bowel from the intestinal stream.
Intestinal atresia and stenosis
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Jason S Frischer, Richard G Azizkhan
Historically, using the very distal segment of the proximal atresia to construct the anastomosis, often resulted in a functional obstruction. A side-to-side anastomosis was also commonly used; however, these patients not only had a functional obstruction but also developed blind-loop syndrome. When dealing with a proximal jejunal atresia, resection of the proximal dilated atretic segment of bowel up to the ligament of Treitz, followed by an end-to-oblique anastomosis can be performed if an adequate length of intestine is present. In the clinical setting of inadequate bowel length, tapering of the dilated bowel on the antimesenteric border should be performed with an end-to-end anastomosis. Attempting to perform intestinal imbrication – to reduce the luminal diameter and restore function while preserving mucosal surface area – has been fraught with a tendency to breakdown resulting in recurrent dilatation.
Vague abdominal pain after Roux-en-Y gastric bypass: not always an internal herniation: case report and literature review
Published in Acta Chirurgica Belgica, 2020
T. Allaeys, V. Dhooghe, S. Nicolay, G. Hubens
Bariatric surgery, more specifically Roux-en-y gastric bypass surgery is gaining more popularity in the management of obesity. Dealing with complaints in these patients has become a daily practise. In literature, the list of recapitulations for short-term and long-term postoperative complications is enormous. Though a lot of them lack the notification of blind loop syndrome causing symptoms like abdominal distension, epigastric pain, nausea and diarrhoea. The purpose of this case report is to raise awareness about this possible diagnosis. Laparoscopic resection of this blind loop is a safe and effective way in the treatment of this syndrome. Needless to say, the emergence of a blind loop should be avoided during the first surgery.
Extrapulmonary tuberculosis
Published in Expert Review of Respiratory Medicine, 2021
Surendra K Sharma, Alladi Mohan, Mikashmi Kohli
In patients with intestinal TB, constitutional symptoms such as fever, weight loss, anorexia, and night sweats are often present. Other common presenting symptoms include colicky abdominal pain, distension, nausea, vomiting, and constipation. Gastrointestinal bleeding may be the presenting symptom in ulcero-constrictive disease. Almost one-third to one-fourth of the patients complains of diarrhea. Recurrent episodes of intestinal colic, partial or complete, acute or subacute intestinal obstruction can be present. Sometimes, patients may present with weight loss and FUO, or features of malabsorption due to blind-loop syndrome [2].