Short bowel arthritis dermatitis syndrome

Intestinal short circuit surgery (jejunum-ileal anastomosis) is a commonly used treatment method for morbid obesity, but it may cause arthritis-dermatitis syndrome and sometimes complications of kidney, liver and blood system diseases. 20% to 80% of cases develop arthritis symptoms 2 to 30 months after surgery. This arthritis is multi-joint symmetrical and migratory, which can affect both upper and lower limb joints. A quarter of patients are chronically affected and cannot predict the duration of arthritis. There was no correlation between joint symptoms and abnormal bowel movements. No radiographic malformations or erosions are seen; sacroiliac joints and spine involvement are uncommon. Various skin abnormalities are present in 66% to 80% of patients. Nodular erythema, macular rash, pimples-like rash, pustular-like rash, urticaria, and nodular dermatitis have been reported. Other clinical manifestations include Raynaud's phenomenon, paresthesia, pericarditis, pleurisy, glomerulonephritis, retinal vasculitis, and superficial thrombophlebitis. Since 1952, a short bowel has been used as a treatment for weight loss. After 11 years, it was found that although this therapy achieved weight loss, it often caused complications including malabsorption and joint symptoms.