Nodular nonsuppurative panniculitis associated with jejunoileal bypass surgery

Abstract

A 32-year-old woman underwent jejunoileal bypass surgery for morbid obesity. Her postoperative course was marked with many of the complications of this type of surgery. In addition, tender, erythematous nodules developed on her legs and abdomen that were grossly and microscopically consistent with nodular nonsuppurative panniculitis. She did not have any condition or disease previously reported to be associated with nodular nonsuppurative inflammation. The nodular panniculitis in this patient appears to be a new complication of small-bowel bypass surgery.

A dermatosis associated with bacterial overgrowth in jejunal diverticula

“…Erythema nodosum-like lesions have also been described by Kennedy (1981). Nodular non-suppurative panniculitis has been described by Williams, Samuelson and Zone (1979) and by Kennedy (t98i). Thus, the clinical spectrum of changes seen in the skin is wide and probably reflects deposition of immunoglobulin in different parts of the dermal vasculature.…”

Jejunoileal bypass as the main procedure in the onset of immune-related conditions: the model of BADAS

“…A biopsy specimen revealed septal and lobular panniculitis and a glucose hydrogen breath test was consistent with bacterial overgrowth. The authors postulated that these rheumatic manifestations might have the same immunologic mechanism of BBS [61,75,76].…”

Joint Manifestations in Gastrointestinal Diseases

“…papulovesicular or vesicopustular [151]. More rarely, erythema nodosum [145,152], ecchymosis [145], nodular nonsuppurative panniculitis [153] and necrobiosis lipoidica [149] are reported. Skin affection usually oc curs shortly before or accompanies articular manifestations [145] and the histopathological picture is that of leukocytoclastic vasculi tis [135].…”