Chronic pseudo-obstruction secondary to side-to-side intestinal anastomosis.

An unusual late complication of side-to-side intestinal anastomosis, chronic small-bowel obstruction with massive proximal ileal dilation despite a widely patent anastomosis, occurred in a patient. The classic blind loop syndrome was not present. Several potential mechanisms are suggested, including regional absence of normal peristalsis on a mechanical basis and bacterial overgrowth. This report adds support to the concept that side-to-side intestinal anastomosis should be avoided whenever possible.