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 the 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 problem 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.