Resolution of late-onset heart and liver failures after reversion of jejuno-ileal bypass: a case report

Scand J Gastroenterol. Jun-Jul 2018;53(7):891-894. doi: 10.1080/00365521.2018.1474944. Epub 2018 May 23.

Abstract

Objectives: Jejuno-ileal bypass (JIB) was a kind of bariatric surgery performed from 1960s to 1980s, able to induce sustainable weight loss by creating a surgical short bowel syndrome.

Materials and methods: We report a case of an octogenarian woman who underwent in the early eighties this kind of surgery with consequent 40 kg weight loss. After 27 years, she first developed a reversible metabolic cardiomyopathy that began with signs and symptoms of heart failure. Thereafter, she was diagnosed with severe intractable liver insufficiency.

Results: Despite her old age, the patient underwent reversal of JIB with consequent early improvement of hepatic function.

Conclusions: This case demonstrate that in case of long-term and life-threatening complications, it is possible to successfully reverse JIB surgery after upto 30 years. The hypothesis on pathophysiology of heart and liver insufficiency are discussed.

Keywords: Jejuno-ileal bypass; dysmetabolic cardiomyopathy; liver insufficiency; nutritional deficiency; small intestine bacterial overgrowth (SIBO).

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Echocardiography, Doppler, Color
  • Female
  • Heart Failure / diagnostic imaging
  • Heart Failure / etiology*
  • Humans
  • Jejunoileal Bypass / adverse effects*
  • Liver Failure / etiology*
  • Obesity, Morbid / surgery*
  • Weight Loss