Blind loop syndrome in children. Malabsorption secondary to intestinal stasis.

In experimental animals and in man, stasis of intestinal contents, particularly in the proximal portion of the small bowel, may produce malabsorption (Donaldson, 1964; Hoet and Eyssen, 1964). The syndrome originally described by Cannon and Murphy (1906) referred to the clinical picture produced by stasis consequent to a side-to-side intestinal anastomosis. The term 'blind loop syndrome' now is applied loosely to malabsorption caused by many congenital and acquired lesions which lead to stasis of intestinal contents. The chief features of the syndrome are steatorrhoea and vitamin B12 malabsorption. Enteric bacteria have been implicated in the pathogenesis of both of these defects (Badenoch, 1958; Donaldson, 1964; Wirts and Goldstein, 1963). Deconjugation of bile salts in the intestinal lumen by certain bacteria may be an important factor in the production of steatorrhoea (Kim et al., 1966; Tabaqchali and Booth, 1966). Vitamin B12 malabsorption probably occurs because of bacterial uptake of the vitamin in the intestinal lumen (Donaldson, 1962). Though Anderson (1966) drew attention to intestinal stasis as a cause of malabsorption in children, the condition has received little emphasis in the paediatric literature generally. Our report describes 4 children with the syndrome, points out the variety of causes from which it may accrue, and emphasizes its clinical and laboratory features.