Bowel bypass syndrome

Last Updated: 2020-08-12

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


Dicken und Seehofer 1979.


Dermatosis with systemic symptoms in obese patients after an ileo-jejunal bypass operation. BADAS is one of the classic neutrophilic dermatoses.

In about 20% of all patients undergoing ileo-jejunal bypass surgery.

After the creation of an artificial short intestine, large parts of the small intestine are bypassed.

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

  • Medical history (Ileo-jejunale bypass operation?)
  • Clinical features
  • Histopathological findings

Noticeably many neutrophil granulocytes, papillary edema, sometimes indicated subepidermal vesicle formation, pustules, necrotising vasculitis.

Both spontaneous healings and long-term, intermittent courses are described.

  1. Ahmed AR , Drenick E. Cutaneous immunofluorescence studies in bowel bypass syndrome. Clin Exp Dermatol 1982;7:477-83.
  2. Dicken CH. Bowel-associated dermatosis-arthritis syndrome: bowel bypass syndrome without bowel bypass. Mayo Clin Proc 1984;59:43-6.
  3. Ely PH. The bowel bypass syndrome: a response to bacterial peptidoglycans. J Am Acad Dermatol 1980;2:473-87.
  4. Geary RJ, Long LL , Mutasim DF. Bowel bypass syndrome without bowel bypass. Cutis 1999;63:17-20.
  5. Simon SI, Sikka JV , Lynfield YL. Bowel bypass syndrome. Cutis 1981;28:545-7, 50, 79.
  6. Tu J, Chan JJ , Yu LL. Bowel bypass syndrome/bowel-associated dermatosis arthritis syndrome post laparoscopic gastric bypass surgery. Australas J Dermatol 2011;52:e5-7.
  7. Varma JR, Pye J , Sinha A. Dermal complication of the bowel bypass syndrome: a case report. J Fam Pract 1993;36:564-6.