Abstract
Experience with thirty-seven intestinal bypass operations in thirty-six patients is reported. Documented severe liver failure occurred in six patients with one death. The failure is manifested by the onset of anorexia, nausea, crampy abdominal pain, and vomiting. The earliest detectable functional abnormality appears to be a decrease in uptake of technetium sulfa colloid by the liver. Bromsulphthalein retention is followed by hypoalbuminemia and hypokalemia. Elevation of the SGOT, SGPT, and alkaline phosphatase levels may occur at this time. Fluid retention with weight gain, peripheral edema, and ascites is rapidly followed by hyperbilirubinemia of the conjugated type. Lesser degrees of abnormal liver function were discovered in eight other patients. Halothane anesthesia, hepatitis-associated antigen, alcoholism, and diabetes do not appear to be factors.
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