DOI: 10.12890/2025_005570
Delayed presentation of blind loop syndrome as iron deficiency anaemia following ileo-colonic anastomosis: a rare postoperative complication
Authors
karamek7@gmail.com
Keywords
Blind loop syndrome, iron deficiency anaemia, ileo-colonic anastomosisAbstract
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
- Conforti AR, Luu S. Blind loop syndrome (archived) 2022 Nov 5. In: StatPearls, StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. http://www.ncbi.nlm.nih.gov/books/NBK587404/ (accessed May 25, 2025).
- Valle RD, Zinicola R, Iaria M. Blind loop perforation after side-to-side ileocolonic anastomosis. World J. Gastrointest Surg 2014;6:156–159. doi:10.4240/wjgs.v6.i8.156
- Card WI. Blind loop syndrome. Proc R Soc Med 1959;52:28–31. doi:10.1177/003591575905200107
- Pal B, Dutta S, Jain A, Reddy A, Nelamangala Ramakrishnaiah VP. Perforated blind pouch: an unusual late complication following lateral anastomosis after a right hemicolectomy. Cureus 2021;13:e15044. doi:10.7759/cureus.15044
- Kubo K, Suzuoki M, Kimura N, Matsuda S, Mabe K, Ohara M, et al. Blind pouch syndrome-associated anastomotic ulcer diagnosed with capsule and double-balloon endoscopy. Intern Med 2019;58:3235–3238. doi:10.2169/internalmedicine.2808-19
- Sinha MK, Sahu S, Hansda U, Kumar A. End-to-side ileo-sigmoid anastomosis and late onset gangrenous diverticulitis: a case report. Cureus 2023;15:e43441. doi:10.7759/cureus.43441
- Willis MP, Dorn MC. Enterolithiasis in a patient with prior bowel resection. Cureus 2024;16: e67894. doi:10.7759/cureus.67894
- Bucknall TE, Wastell C. Ileocolic blind loops following side-to-side anastomoses. J R Soc Med 1980;73:882–884. doi 10.1177/014107688007301212
