0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Hepatic Dysfunction Following Bypass Operation

Seyed N. Moussavian, MD
JAMA. 1977;237(23):2469. doi:10.1001/jama.1977.03270500021004.
Text Size: A A A
Published online

To the Editor.—  Ames and colleagues have advocated the use of parenteral nutrition in the treatment of hepatic dysfunction following jejunoileal bypass for morbid obesity (235:1249, 1976). I would like to make some suggestions related to the cause of hepatic complications following bypass operation.Although choline deficiency has been shown to be involved in the development of fatty liver in rats,1 it has not been shown to be a causative factor in human fatty liver. Moreover, exact mechanisms by which protein deficiency causes fatty liver in man and experimental animals are not clear.2 Also, the suggestion of the authors that "breakdown of ingested choline by bacterial overgrowth in the bypassed intestine [occurs]" is not clear, especially since, with end-to-end anastomosis (which their patient had), reflux of intestinal contents into the bypassed segment of intestine is unlikely.Regarding the use of parenteral nutrition in bypass patients, none of the

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();