Markedly elevated lipase as a clue to diagnosis of small bowel obstruction after gastric bypass.

We describe an afferent loop obstruction in a patient who had a subtotal gastrectomy with Roux-en Y gastrojejunostomy for postvagotomy syndrome. The clinical presentation and initial studies suggested acute pancreatitis. A computed tomography scan showed a small bowel obstruction distal to the jejunojejunal anastomosis. The patient was taken to the operating room for an exploratory laparotomy, lysis of adhesions, and closure of her jejunostomy. Surgery was successful at resolving her obstruction. In any Roux-en-Y gastric reconstruction or gastric bypass patient presenting to the emergency department with abdominal pain and elevated transamines or pancreatic enzymes, a small bowel obstruction must be considered. Additional imaging with a computed tomography scan is advocated, as well as surgical consultation.

[Animal experiments in stagnant loop syndrome]. / Tierexperimentelle Untersuchungen zum Stagnant-Loop-Syndrom.

Using the perfusion technique, the absorption of water, sodium, and glucose was studied in a partial occlusion of the intestine. In this study we investigated the mucosal enzyme, the metabolic changes of the small bowel wall, and the morphology of the mucosa. The reason for the decreased absorption of glucose, sodium, and water in the prestenotic phase may be the increased proliferation of the mucosa. The decreased absorption of the glucose, sodium and water in the poststenotic phase may be caused by an atrophy of the mucosa.