A 59 yr old woman who had multiple ileal ulcers following side-to-side anastomosis without bowel resection is reported. She had a surgical history of adhesive ileus 15 yrs earlier, and was admitted with a complaint of lower abdominal pain. A barium meal study showed a stagnant and dilated distal ileum. At laparotomy, a previously performed side-to-side ileal anastomosis was encountered, and a markedly dilated bypassed loop was recognized. The affected intestine was resected revealing multiple longitudinal ulcers and small shallow ulcers mostly located on the mesenteric side. This feature is similar to that of ischemic enteritis. This case further supports the fact that when side-to-side anastomosis is performed as a bypass operation, multiple ulcers may develop in a bypassed loop after a long period of time.
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