Blind loop syndrome
| Classification according to ICD-10 | |
|---|---|
| K90.2 | Blind loop syndrome, not elsewhere classified |
| K91.1 | Syndromes of the operated stomach |
| Q43.8 | Other specified congenital malformations of the bowel |
| ICD-10 online (WHO version 2019) | |
The blind loop syndrome ( Engl. Blind loop syndrome ), also under the synonyms blind bag syndrome and Blind loop syndrome known is the maldigestion and malabsorption (ie impaired absorption) of fats , carbohydrates , vitamins and minerals that arise in the off or be sacked intestine can.
The blind loop syndrome is a consequence of conditions or surgical interventions that lead to the elimination of a certain section of the intestine, e.g. B. Diverticula , bypassing enteric anastomoses in the small intestine area.
Chronic congestion of the intestinal contents in the blind loop ( chyme stagnation ) can lead to bacterial overgrowth, which leads to irritation of the mucous membranes and digestive disorders. The bacterial colonization caused by the stasis leads to an increased consumption of vitamin B 12 ( intestinal flora ), which leads to a vitamin B 12 deficiency with corresponding symptoms, and the bile acids are quickly deconjugated , which leads to diarrhea. Another mechanism for the development of diarrhea appears to be enterotoxins produced by bacteria .
Symptoms
By deconjugation of bile acids leads to a Chologenic diarrhea ( diarrhea ), in addition to malabsorption of fats leads to steatorrhea , that is to a disposal of fatty chair. This is accompanied by abdominal pain and nausea, and as complications of diarrhea, hypocalcemia and weight loss can occur. In addition, there is usually a vitamin B 12 deficiency, which can progress to pernicious anemia and neurological damage.
therapy
The therapy can be carried out surgically or medically. Surgically, the blind sac can be removed ( blind sac resection ) or the anastomosis can be converted into a physiological end-to-end anastomosis . Medication is used for the control of bacterial colonization tetracyclines , for binding of free bile acids can cholestyramine be applied. A parenteral vitamin B 12 - supplementation would be advisable to avoid the complication of anemia.
literature
- Werner Böcker, Helmut Denk, Philipp Heitz (Eds.): Pathology (Urban & Fischer, Munich, 3rd edition 2004, ISBN 3-437-42381-9 )
- M. Müller: Surgery for study and practice (Medical Publishing and Information Services , Breisach, 5th edition 2000, ISBN 3-929851-04-0 )
Web links
- U. Rabast: Bacterial overgrowth of the small intestine - blind loop syndrome. In: Current nutritional medicine. 29, 2004, p. 153, doi : 10.1055 / s-2003-814995 .
