Brown bowel syndrome: a rare malnutrition-related complication of bariatric surgery

espanolCaso clinico: presentamos el caso de un paciente varon de 44 anos que presento diarrea incontrolable, desnutricion proteica-calorica severa y deficiencias de multiples vitaminas, junto con neuropatia periferica diez anos despues de derivacion biliopancreatica clasica (DBP). Se sometio a soporte nutricional y la cirugia se convirtio en un bypass gastrico en Y de Roux, con un resultado sin complicaciones. La histopatologia del intestino resecado revelo una lipofuscinosis de la capa muscular compatible con el sindrome del intestino marron. Discusion: el sindrome de intestino marron es una complicacion rara de la desnutricion que se puede observar despues de la DBP. Se asocia a deficiencia de vitamina E. Despues de la recuperacion con soporte nutricional, se debe indicar una reoperacion que alargue el canal comun y, por lo tanto, minimice el grado de malabsorcion en estos casos. EnglishCase report: we present the case of a 44-year-old male who presented with uncontrollable diarrhea, severe protein-calorie malnutrition and multiple vitamin deficiencies, along with peripheral neuropathy ten years after classic biliopancreatic diversion (BPD). He underwent nutritional support and had the surgery converted to a Roux-en-Y gastric bypass, with an uneventful outcome. The histopathology of the resected bowel revealed lipofuscinosis of the muscular layer compatible with brown bowel syndrome. Discussion: brown bowel syndrome is a rare complication of malnutrition that can be observed after BPD. It is associated with vitamin E deficiency. After recovery with nutritional support, a reoperation that elongates the common channel, and thus minimizes the degree of malabsorption, should be indicated in these cases.