Vasculitis associated with intestinal bypass surgery

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Abstract
Necrotizing vasculitis with tenosynovitis arthralgia/arthritis syndrome developed in 2 cases after intestinal bypass surgery. Each of the patients had jejunoileostomies and the excluded segment was placed in an ilealcolonic anastomosis. Apparently the attachment of the excluded segment to the large intestine predisposes it to increased bowel overgrowth of bacteria. The bacteria or their debris may have served as antigens for circulating immune complexes detected in the patients by 1 or more techniques. Patients who had an end-to-side anastomosis may be less predisposed to the more severe vasculitis syndrome because there is less likelihood of bacterial overgrowth in the bypassed intestinal segment.