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Bowel-bypass syndrome
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Bowel-bypass syndrome

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Contributors: Scott W. Dunbar MD, Noah Craft MD, PhD
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Synopsis

Bowel-associated dermatosis-arthritis syndrome (BADAS), also known as bowel-bypass syndrome and blind loop syndrome, is a well-documented complication of bariatric surgery characterized by recurrent inflammatory papules and vesicopustules, fever, malaise, and arthritis. Onset ranges from 6 weeks to 5 years postoperatively. Each episode lasts for several days, spontaneously resolves, and often relapses within 1-6 weeks. The pathogenesis of BADAS is poorly understood, but postsurgical gut stasis, bacterial overgrowth, and consequent stimulation of innate and adaptive immune systems are implicated.

BADAS occurs in up to 20% of patients who undergo jejunoileal bypass for morbid obesity. Women appear to have higher incidence of rheumatologic complications following bowel surgery, but the exact sex predilection is unknown. The arthritis of BADAS is more common in females.

BADAS was originally reported after jejunoileal bypass but has been associated with multiple other surgical procedures, including biliopancreatic diversion and surgeries resulting in blind loops, as well as Crohn disease and ulcerative colitis in the absence of bowel surgery.

Codes

ICD10CM:
K91.2 – Postsurgical malabsorption, not elsewhere classified

SNOMEDCT:
402858006 – Bowel-bypass syndrome

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Last Updated: 08/31/2017
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Bowel-bypass syndrome
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Bowel-bypass syndrome (Cutaneous) : Erythema, Trunk, Blanching macule, Smooth papules, Pustules, Upper arms
Clinical image of Bowel-bypass syndrome
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