Imbalance in brush border enzyme activities as a possible cause of hepatic dysfunction after jejunoileal bypass in the rat.

Previous work in our laboratory and in others suggest that protein malnutrition plays an important role in the pathogenesis of hepatic dysfunction after jejunoileal bypass for morbid obesity. This experimental study was undertaken to attempt to correlate hepatic dysfunction (the criterion used was the bromsulphalein clearance) to morphological and enzymatic adaptation of the functioning intestine in the rat. It was observed that the period of impaired bromsulphalein clearance is concomitant with a slight ileal morphological adaptation and especially with a period of selective adaptation of maltase and sucrase activities, whereas there is no increase in aminopeptidase activity. These data support the hypothesis that after jejunoileal bypass a preferential absorption of carbohydrates along with a protein deficiency state could occur and as in kwashiorkor it results in an impaired nutritional status, a major contributing factor to bypass-induced liver injury.