Blind loop syndrome after biliopancreatic diversion: a diagnostic challenge

Background: Biliopancreatic diversion (BPD) according to Scopinaro's method is a safe and effective technique for treatment of morbid obesity. In this operation a side-to-side enteroenterostomy is created 60 cm proximal to th e ileocecal valve. Malabsorption of fat and starch is one of the main goals of the BPD. Ingestion of an excess of fat leads to steatorrhea. As a side- effect, malabsorption of iron, calcium and other elements can occur causing anemia and hypocalcemia. The blind loop syndrome gives the same symptoms. Methods: A lady was admitted with a long history of steatorrhea, anemia and hypocalcemia due to a blind loop syndrome after a BPD. The diagnostic prob lem in this patient is illustrated. Results: The diagnosis was only made at exploratory laparotomy. Conclusion: The blind loop syndrome was then treated with resection of the blind loop and antibiotics.