Bowel bypass syndrome

Last Updated: 2020-08-12

Author(s): Anzengruber, Navarini

Dicken und Seehofer 1979.

BADAS.

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.

  • Re-operation where possible
  • Doxycycline p.o. 200 mg 1x daily for about 3 weeks
  • Metronidazole p.o. up to 1,5 g/day
  • Low-dose oral glucocorticoids
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