Delayed presentation of blind loop syndrome as iron deficiency anaemia following ileo-colonic anastomosis: a rare postoperative complication

Authors

• Lana El Chal Department of Internal Medicine, University of Balamand, Beirut, Lebanon
• Philippe Attieh Department of Internal Medicine, University of Balamand, Beirut, Lebanon
• Cynthia Ghraizi Department of Internal Medicine, University of Balamand, Beirut, Lebanon
• Ibtihaj Saad Department of Internal Medicine, University of Balamand, Beirut, Lebanon
• Karam Karam Department of Gastroenterology and Hepatology, University of Balamand, Beirut, Lebanon
• Elias Fiani Department of Gastroenterology and Hepatology, University of Balamand, Beirut, Lebanon

karamek7@gmail.com

Keywords

Abstract

Blind loop syndrome is a malabsorptive condition resulting from intestinal stasis, which promotes bacterial overgrowth and leads to various gastrointestinal and systemic manifestations. It often occurs secondary to anatomical or motility abnormalities, particularly after gastrointestinal surgeries. We present the case of a 75-year-old male with a history of colon cancer status post right hemicolectomy with ileo-colonic anastomosis, who was incidentally found to have severe iron deficiency anaemia during a routine check-up. One year prior, follow-up endoscopies were normal. However, recent investigations revealed a hyperplastic polyp in the gastric cardia and, more importantly, a blind loop with ulcerations distal to the ileum on colonoscopy. Biopsies confirmed ulcerated ileal/colonic mucosa with granulation tissue. The patient underwent surgical resection of the blind loop with the creation of an ileo-transverse anastomosis. Postoperatively, he recovered well and was discharged on a regular diet. This case illustrates the importance of considering blind loop syndrome in patients with a history of bowel surgery who present with non-specific symptoms such as anaemia. It also highlights the potential for delayed onset and the diagnostic value of endoscopy when routine workups are inconclusive. Surgical correction remains the definitive treatment in anatomically driven cases, offering significant symptomatic relief and prevention of further complications.

References