Bowel bypass syndrome

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.


Dicken and Seehofer 1979.


A dermatosis with systemic symptoms occurring in obese patients after ileo-jejunal bypass surgery. BADAS is one of the classic neutrophilic dermatoses.

Approximately 20% of all patients who have ileojejunal bypass surgery.

After an artificial short bowel is created, large parts of the small bowel are bypassed.

  • Erythematous, coarse papules and pustules localised to the trunk as well as the upper and lower extremities
  • Flu-like symptoms, joint symptoms (due to circulating immune complexes and cryoglobulins) cryoglobulinemia, tendinitis
  • The disease may be associated with xerosis cutis, erythema nodosum and acrodermatitis enteropathica-like skin lesions

  • History (Ileojejunal bypass surgery?)
  • Clinical
  • Histopathological findings

Suspiciously many neutrophilic granulocytes, papillary oedema, sometimes suggested subepidermal vesicle formation, pustules, necrotising vasculitis.

Spontaneous healing as well as long-term, intermittent courses have been described.

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