Pneumatosis Intestinalis

Abstract

AS MORE experience is gained with jejunoileal bypass, more unanticipated complications are being discovered. A complication not yet reported is pneumatosis intestinalis in the defunctionalized small-bowel segment. This complication occurred in one patient in our series. Report of a Case A 46-year-old man weighing 154.5 kg (340 lb) underwent jejunoileal bypass for morbid obesity. He had prior episodes of severe cardiopulmonary failure. No endocrine abnormalities were discovered during preoperative evaluation. Upper gastrointestinal and small-bowel roentgenographic series, barium enema examination, and oral cholecystogram were normal. After treatment of the cardiac and pulmonary failure with digitalis, diuretics, and respirator therapy, the patient underwent a jejunoileal bypass with 35.5 cm of jejunum, anastomosed end-to-end to the terminal 10 cm of ileum. The defunctionalized small-bowel segment was closed proximally and fixed to the root of the small-bowel mesentery, and the distal segment anastomosed end-to-side to the sigmoid colon. The postoperative course was complicated by