Complications of Intestinal Bypass for Obesity

During the last ten years there have been many reported cases of surgical treatment of obesity in man. The earlier reports dealt with jejunocolonic bypasses; the functional jejunum measured approximately 2 to 3 feet from the ligament of Treitz. Anastomoses have been made either at the transverse colon or at the ascending colon. Complications that have been described were characterized by anemia, hypoproteinemia, and a variety of electrolyte imbalances. Fatty degeneration of the liver has also been reported. There seem to be only two communications discussing fatal complications in patients who have had antecedent surgical bypass procedures for obesity. Hypocalcemia was reported to cause the death of one patient.1A communication in the May issue of theArchives of Surgery2reports progressive intractable congestive heart failure with pulmonary edema, and progressive hepatic necrosis with hepatic coma as the causes of death in two additional patients following bypass procedures.