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A 65-year-old gentleman presented with a history of abdominal distension and difficulty in walking 10 years after a Polya partial gastrectomy. Clinical history and neurological examination suggested an axonal sensory neuropathy. A computed tomographic scan of the abdomen showed a large afferent jejunal loop, and a hydrogen breath test confirmed small-bowel bacterial overgrowth secondary to the blind loop syndrome. Serological tests revealed low copper levels, which are a cause of a myeloneuropathy. The trace element deficiency occurred as a consequence of small-bowel bacterial overgrowth, and with antibiotic treatment of the bacterial overgrowth and copper supplementation his symptoms markedly improved.

Original publication

DOI

10.1097/MEG.0b013e328349d030

Type

Journal article

Journal

Eur J Gastroenterol Hepatol

Publication Date

10/2011

Volume

23

Pages

952 - 953

Keywords

Aged, Blind Loop Syndrome, Copper, Gait Ataxia, Gastrectomy, Humans, Male, Spinal Cord Diseases, Tomography, X-Ray Computed, Walking