Me. Murray et al., RADIOLOGICAL DEMONSTRATION OF SMALL-BOWEL ADAPTATION FOLLOWING MODIFIED SCOPINARO PROCEDURE FOR MORBID-OBESITY, Obesity surgery, 3(2), 1993, pp. 165-168
Upper gastrointestinal contrast studies were carried out on 24 patient
s at progressive time intervals following gastric partition with parti
al biliopancreatic bypass (modified Scopinaro procedure) for morbid ob
esity. Roentgenograms taken on standardized equipment were compared in
order to document adaptive changes occurring in the small bowel with
time following the procedure. Mucosal fold thickness and bowel lumen c
alibre within the terminal ileum were found to increase significantly
with (log) time. Such adaptation of the ileum is well recognized follo
wing jejunoileal bypass, but radiological demonstration after biliopan
creatic bypass has not been described previously. Mucosal hypertrophy
and increase in bowel lumen calibre should be recognized as normal ada
ptive changes in the small bowel and not be misinterpreted as evidence
of underlying pathology. Whilst adaptation following jejunoileal bypa
ss undoubtedly contributes to eventual weight gain following surgery,
this detrimental effect following the modified Scopinaro procedure app
ears to be negated by the reduced intake and maldigestion imposed by t
his procedure.