A Case of Blind Loop of the Ilenm Associated with Protein-rosing Enteropathy Morio Tatsumura 1 1Asanogawa Hospital, Kanazawa City pp.229-233
Published Date 1970/2/25
DOI https://doi.org/10.11477/mf.1403111204
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 A 60-year-old female patient is presented in whom chief complaints were massive edema in the legs and mild diarrhea. On admission, the serum protein was 3.4 gm/dl. Radiological studies of the upper gastrointestinal tract gave no information but those of the small intestine disclosed loop formation and remarkable dilatation of the terminal portion of the ileum. The parenteral administration of a relatively large amount of serum albumin failed to elevate the decreased serum protein levels. From the past history, clinical course ancl radiological findings of the ileum, a diagnosis was made of blind loop associated with protein-losing enteropathy. The blind loop was resected surgically. The patient showed dramatic improvement with striking rapid elevation of serum protein levels from 4.3 gm/dl immediately prior to the operation up to 6.0gm/dl during a postoperative period op 19 days without any supplemental treatment for hypoproteinemia. The serum protein levels estimated on the 38th and 76th day after operation were 7.0 gm/dl and 7.4 gm/dl, respectively. Findings at the operation disclosecl that the blincl loop found in the ileum had been formed by the antecedent ileoileostomy done for intestinal obstruction, and later regional tuberculous peritonitis had developed there. Histological examinations revealed tuberculous changes in the regional mesentery and lymph nodes, and also markedly dilated lymph vessels in the submucosal layer of the affected ileum. The mucosal layer seemed to be almost unchanged. It is concluded that the protein-losing enteropathy observed in this case was induced by regional tuberculous peritonitis which had developed on the blind loop.

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