Brown bowel syndrome: an unusual cause of massive dilatation of the colon.

Robinson, M.H.; Dowling, Barbara; Clark, Jane; Mason, C H

doi:10.1136/gut.30.6.882

Cited by 15 publications

(9 citation statements)

References 1 publication

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“…Crohn’s disease, ulcerative enteritis, Whipple disease), and intestinal lymphangiectasia. 3 , 8 There is predominantly circular muscle hypertrophy with ceroid lipofuscin-like deposits. Microscopically, the deposits are seen predominantly within the smooth muscle cells of the muscularis propria, muscularis mucosae, and surrounding blood vessels, which gives the typical gross appearance of “brown bowel.” The deposits can sometimes result in dysmotility of the gastrointestinal (GI) tract due to ineffective peristalsis.…”

Section: Discussionmentioning

confidence: 99%

Severe chronic bowel obstruction associated with brown bowel syndrome

Wongworawat

Propst

Raza

et al. 2020

SAGE Open Medical Case Reports

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A 61-year-old alcoholic male with history of cholecystectomy presented with a 20-year history of recurrent bowel obstruction and a 30 lb weight loss. After numerous attempts at conservative management, exploratory laparotomy was performed, which showed no mechanical cause. Despite no clear etiology, the obstruction persisted and intensified. A follow-up computed tomography scan revealed a small bowel obstruction with concurrent megacolon. A total abdominal colectomy was performed, with ileostomy. Grossly, there was intestinal dilation up to 15 cm with prominent brown discoloration of bowel wall. No strictures or other fixed obstruction were identified. Microscopic examination revealed prominent lipofuscin-like pigment deposition, involving the muscularis propria, muscularis mucosae, and vascular smooth muscle. Histochemical staining was positive for periodic acid–Schiff and negative for iron and calcium, consistent with lipofuscin. The gross and histologic findings fit with brown bowel syndrome. Brown bowel syndrome is a very rare condition characterized by lipofuscin deposits predominantly within the smooth muscle of the muscularis mucosae and/or muscularis propria that imparts a brown color to the bowel. It is generally thought to be a smooth muscle mitochondrial myopathy due to chronic vitamin E deficiency secondary to fat malabsorption syndromes, resulting in free radicals causing peroxidation of unsaturated membrane lipids with accumulation of lipofuscin. Brown bowel syndrome may be seen in patients with alcohol abuse, maldigestion, chronic bowel inflammation, and intestinal lymphangiectasia. Our patient’s severe chronic intestinal pseudo-obstruction, low levels of certain fat-soluble vitamins (A, D, and E), significant weight loss and history of cholecystectomy with alcohol abuse correlates with brown bowel syndrome clinically.

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Section: Discussionmentioning

confidence: 99%

Severe chronic bowel obstruction associated with brown bowel syndrome

Wongworawat

Propst

Raza

et al. 2020

SAGE Open Medical Case Reports

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“…Brown bowel syndrome is a rare entity which may be asymptomatic but also may have serious clinical implications. One of them is massive intestine dilation causing sub-obstructive symptoms necessitating partial intestinal resection [3]. Although BBS is very rare, it should be taken into consideration in cases with major intestinal dilatation in patients without mechanical obstruction suffering from a malabsorption syndrome.…”

Section: Introductionmentioning

confidence: 99%

Quiz Correct answer to the quiz. Check your diagnosis Brown bowel syndrome (intestinal lipofuscinosis) – a and review of the literature

Białas¹,

Demczuk²,

Dyduch³

et al. 2013

pjp

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Brown bowel syndrome (BBS) is a very rare condition occurring in association with malabsorption syndromes. It is characterised by deposition of granular, brown pigment (lipofuscin or ceroid) in intestinal smooth muscle cells. Rarely BBS can be complicated by distention of any segment of the bowel. We present a case of BBS associated with massive dilation of first loop of the small intestine and moderate dilation of the sigmoid colon with functional intestinal disturbances requiring surgical intervention in an 11-year-old boy.

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“…Brown bowel syndrome has been described in the setting of states of severe malnutrition such as celiac disease and endemic sprue [1,2]. Although the pathogenesis is not fully understood, vitamin E deficiency has been considered to be a putative cause of brown bowel syndrome [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Brown Bowel Syndrome Secondary to Jejunoileal Bypass: The First Case Report

et al. 2009

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A 58-year-old woman with a surgical history of jejunoileal bypass in 1980 for weight reduction sought medical attention with multiple complaints. The patient had not been taking any nutritional supplements since her bypass surgery, 26 years previously. She was found to have osteomalacia, chronic diarrhea, secondary hyperparathyroidism, and hyperoxaluria with a frequent history of nephrolithiasis. Because of her severe osteodystrophy and metabolic complications, reversal of her jejunoileal bypass was recommended. Reversal of the jejunoileal bypass with a sleeve gastrectomy was performed. Laparotomy revealed brown discoloration of the entire alimentary limb with atrophy of the bypassed intestinal limb. Histologic examination of the resected small bowel demonstrated brown pigment deposits within smooth muscle cells of the bowel wall. The pigment stained positive with Fontana-Masson most likely representing lipofuscin. We report a case of brown bowel syndrome complicating jejunoileal bypass, the first case reported in the literature to the best of our knowledge.

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Brown bowel syndrome: an unusual cause of massive dilatation of the colon.

Cited by 15 publications

References 1 publication

Severe chronic bowel obstruction associated with brown bowel syndrome

Severe chronic bowel obstruction associated with brown bowel syndrome

Quiz Correct answer to the quiz. Check your diagnosis Brown bowel syndrome (intestinal lipofuscinosis) – a and review of the literature

Brown Bowel Syndrome Secondary to Jejunoileal Bypass: The First Case Report

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