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Rare case of bypass arthritis in a patient with short bowel syndrome

Introduction: Intestinal bypass as a method for reducing weight in morbid obesity has known side effects (short and long term), including arthritis that seem to be due to bacterial overgrowth in blind loop of intestine or colonization of bacteria. Although arthritis is common in blind loop syndrome, it has never been reported in massive intestinal resection and jejune-terminalileostomy patients with blind loop. Case report: Our case is a 21 year old female that referred to us for evaluation of arthritis. This complaint started 4 years age after multiple abdominal surgery and intestinal resection that had been done due to appendicitis, adhesive band and strangulation. Conclusion: Clinical and para-clinical evaluation for this complaint had been done during the past 6-7 years. All other etiologic factors were evaluated and ruled out. Her sign and symptom was unresponsive to prednisolon (10-15mg) and aspirin (1500-2000mg). At the last hospital admission prednisolon and aspirin were discontinued and sulfasalazine (1500 mg) started. After 10 days her arthritis sign and symptom resolved.