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Acute afferent loop syndrome: a true emergency. A case report.

TitleAcute afferent loop syndrome: a true emergency. A case report.
Publication TypeJournal Article
Year of Publication2009
AuthorsBallas, K. D., Rafailidis S. E., Konstantinidis H. D., Pavlidis T. E., Marakis G. N., Anagnostara E., & Sakadamis A. K.
JournalActa Chir Belg
Volume109
Issue1
Pagination101-3
Date Published2009 Jan-Feb
ISSN0001-5458
KeywordsAbdominal Pain, Acute Disease, Afferent Loop Syndrome, Dilatation, Pathologic, Duodenum, Emergencies, Fatal Outcome, Gastrectomy, Humans, Male, Middle Aged, Peptic Ulcer, Postprandial Period, Time Factors, Tomography, X-Ray Computed
Abstract

Afferent loop syndrome is a relatively rare complication after subtotal gastrectomy. We present a late onset of afferent loop obstruction, in a patient who underwent Billroth II gastrectomy with Roux-Y reconstruction for a gastric ulcer 27 years ago. A 60-year-old male was admitted to the hospital with an 8-hour history of acute epigastric pain, associated with vomiting, fever and signs of sepsis. Laboratory tests revealed leukocytosis, elevated liver function tests and high serum amylase. An obstructed afferent loop appeared on CT as a fluid filled tubular mass, crossing the middle line between the aorta and the mesenteric vessels. Advanced sepsis was also seen in the peripancreatic and retroperitoneal region. Although the patient was operated on immediately after diagnosis with reconstruction of Roux-Y anastomosis, he died 12 hours later. Afferent loop syndrome is quite uncommon, and must be suspected in patients who have undergone subtotal gastrectomy. Clinical manifestations of the syndrome are usually non-specific. CT is the examination of choice and surgery the first choice treatment.

Alternate JournalActa Chir. Belg.
PubMed ID19341207

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