Brown Bowel Syndrome

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Abstract
Brownish discoloration of the muscular layer of the small bowel was first described in animals maintained on Vitamin E deficient diets. Clinically, this pigmentation has most frequently been found in association with the malabsorption syndrome regardless of etiology, and recent work has revealed that Vitamin E deficiency is a concommitant problem in a large percentage of cases, most likely because of failure to absorb this fat soluble vitamin. Assymptomatic, gross, brownish discoloration of the bowel was incidently discovered at laparotomy in a 50 year old white male with chronic pancreatitis and pancreatic insufficiency. A detailed laboratory and pathologic investigation established the patient to have severe malabsorption of fat and secondary Vitamin E deficiency. "Brown Bowel" Syndrome is therefore proposed as the anatomic hallmark of Vitamin E deficiency, and should alert the clinician, surgeon, and pathologist to the possibility of a malabsorption state.
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