Spondyloarthropathy After Ampullary Carcinoma Resection

Abstract

The development of bowel-bypass syndrome complicating the Whipple procedure for biliary tract carcinoma is described here for the first time. A 56-year-old HLA-B27 + man, treated with excision of adenocarcinoma of the ampulla of Vater, developed an undifferentiated spondyloarthropathy, initially unresponsive to nonsteroidal anti-inflammatory drugs and doxycycline, but eventually controlled with sulfasalazine and tapered corticosteroids. This condition represents another example of a rheumatic syndrome occurring after disruption of gastrointestinal tract continuity and likely development of small bowel bacterial overgrowth.

Pancreatic Surgery

“…Reports show as high as 40% of patients with pancreatic insufficiency have SIBO 58 , 115 . Single case reports have been published on both a nonoperative and PD pancreatic cancer patient subsequently developing SIBO 116 , 117 . In addition, up to 77% of gastrectomy patients 6 months postoperatively may have this condition 118 .…”