Afferent Loop Syndrome
Blind Loop Syndrome
Gastroenterostomy
Non-surgical treatment for afferent loop syndrome in recurrent gastric cancer complicated by peritoneal carcinomatosis: percutaneous transhepatic duodenal drainage followed by 24-hour infusion of high-dose fluorouracil and leucovorin. (1/7)
Afferent loop syndrome (ALS) is a debilitating complication of recurrent gastric cancer. Surgical intervention is usually not feasible in the face of poor general performance, presence of advanced peritoneal carcinomatosis and limited survival of the patients. Non-surgical approaches include internal drainage by stenting at the stenotic or anastomotic site and external drainage via the percutaneous routes. Percutaneous transhepatic duodenal drainage (PTDD) has been shown to provide effective palliation for ALS, but long-term catheterization is usually inevitable. We hereby present two cases of recurrent gastric cancer whose ALS was successfully treated with PTDD followed by weekly 24-h infusion of high-dose 5-fluorouracil and leucovorin (HDFL). PTDD rapidly ameliorated the incapacitating symptoms of ALS, and the effective, low-toxicity chemotherapy subsequently led to tumor regression, restoration of bowel patency and removal of the drainage tube. At present, both patients have remained ALS-free and drainage-free for 16 and 17 months, respectively. Our results indicate that this non-surgical approach with PTDD followed by weekly HDFL could serve as a safe and effective treatment for ALS in recurrent gastric cancer complicated by peritoneal carcinomatosis. (+info)Laparoscopy in afferent loop obstruction presenting as acute pancreatitis. (2/7)
BACKGROUND: We describe an afferent loop obstruction caused by an adhesion band in a case of distal gastrectomy with Roux-en-Y end-to-side jejunal anastomosis for cancer. METHODS: An initial clinical presentation of acute pancreatitis was ruled out by a computed tomography scan, which revealed intestinal obstruction; it was then confirmed on laparoscopy. Definitive treatment was laparoscopic adhesiolysis. A complete review of the literature concerning afferent loop obstructions is presented. RESULTS: The treatment was successful, with minimal postoperative pain, and the 5-day hospital stay was uncomplicated. The patient remains asymptomatic at 1-year follow-up. CONCLUSIONS: The authors advocate minimally invasive surgery as a complete diagnostic and therapeutic alternative to emergency laparotomy in cases where afferent loop syndrome is suspected, and acknowledge that prompt surgery has a higher rate of success and reduces operative morbidity and mortality. (+info)Malignant afferent loop obstruction following pancreaticoduodenectomy: report of two cases. (3/7)
We report two cases of malignant afferent loop obstruction following pancreaticoduodenectomy (PD). Case 1. A 70-year-old woman, who had undergone PD for pancreatic cancer, was referred to our hospital because of fever, jaundice, and abdominal pain. Ultrasonography and abdominal computed tomography demonstrated dilatation of a small bowel loop in the right upper quadrant. Laparotomy confirmed the diagnosis of local recurrent tumor causing occlusion of the afferent limb, and Roux-en-Y bypass was performed. Case 2. A 72-year-old man, who had undergone PD for cancer of the major papilla, was hospitalized with a high-grade fever and epigastric pain. Ultrasonography and abdominal computed tomography revealed a dilated afferent loop and multiple masses in liver. At laparotomy, widespread carcinomatosis was found to have caused afferent loop obstruction, and surgical bypass was performed. In conclusion, the surgical bypass seems to be an effective palliative treatment for afferent loop syndrome after PD. (+info)Biliary stone causing afferent loop syndrome and pancreatitis. (4/7)
We report the case of an 84-year-old female who had a partial gastrectomy with Billroth-II anastomosis 24 years ago for a benign peptic ulcer who now presented an acute pancreatitis secondary to an afferent loop syndrome. The syndrome was caused by a gallstone that migrated through a cholecystoenteric fistula. This is the first description in the literature of a biliary stone causing afferent loop syndrome. (+info)Using multidetector-row CT for the diagnosis of afferent loop syndrome following gastroenterostomy reconstruction. (5/7)
(+info)Enterolith causing acute afferent loop syndrome after Billroth II gastrectomy: a case report. (6/7)
Enterolith is a rare cause of afferent loop obstruction following Billroth II gastrectomy. We report a case of acute afferent loop syndrome (ALS) due to a huge enterolith, necessitating prompt surgery. The clinical pattern may mimic acute cholangitis and/or pancreatitis. Delayed diagnosis may result in severe complications such as bowel ischemia or perforation. Only 14 reported cases of enterolith causing afferent loop obstruction were found in the English literature. (+info)Radionuclide demonstration of small-bowel anatomy in the afferent-loop syndrome: case report. (7/7)
Radionuclide imaging with I-131 rose bengal and orally administered Tc-99m colloid was successfully used to show the presence of an afferent loop that was not visualized by radiographic, endoscopic, or ultrasonic procedures. (+info)Afferent loop syndrome is a relatively uncommon complication that can occur after certain gastrointestinal surgeries, particularly those involving the small intestine. The afferent loop refers to a portion of the small intestine that carries digestive secretions from the liver and pancreas towards the main part of the small intestine (the jejunum).
In afferent loop syndrome, this loop becomes obstructed or narrowed, leading to a backup of digestive enzymes and fluids. This can cause various symptoms, including abdominal pain, nausea, vomiting, and diarrhea. The vomit may contain bile, which is a yellowish-green fluid produced by the liver, indicating that the obstruction is located in the afferent loop.
Afferent loop syndrome can be caused by several factors, including post-surgical adhesions (scar tissue), inflammation, or tumors. The diagnosis of afferent loop syndrome typically involves imaging tests such as CT scans or upper gastrointestinal series to visualize the obstruction. Treatment may involve endoscopic procedures to clear the obstruction or surgery to repair or bypass the affected portion of the intestine.
Blind Loop Syndrome is a medical condition that occurs when there is an abnormal pocket or pouch in the small intestine that allows digested food to bypass the normal digestive process. This can lead to bacterial overgrowth, malabsorption of nutrients, and various gastrointestinal symptoms such as bloating, cramps, diarrhea, and weight loss.
The blind loop can be caused by a number of factors, including congenital abnormalities, surgical complications, or structural changes due to diseases such as Crohn's disease or cancer. The diagnosis of Blind Loop Syndrome is often made through radiologic studies, such as a barium X-ray or CT scan, and can be confirmed with a breath test that measures the amount of hydrogen or methane gas produced by intestinal bacteria.
Treatment typically involves antibiotics to eliminate the overgrowth of bacteria, followed by surgery to correct the underlying anatomical abnormality. In some cases, medication may also be prescribed to manage symptoms and improve nutrient absorption.
Gastroenterostomy is a surgical procedure that creates an anastomosis (a connection or junction) between the stomach and the small intestine, usually between the stomach's lesser curvature and the jejunum (the second part of the small intestine). This procedure is often performed to bypass a diseased or obstructed portion of the gastrointestinal tract, such as in the case of gastric ulcers, tumors, or other conditions that prevent normal digestion and absorption.
There are different types of gastroenterostomy procedures, including:
1. Billroth I (or "gastroduodenostomy"): The stomach is connected directly to the duodenum (the first part of the small intestine).
2. Billroth II (or "gastrojejunostomy"): The stomach is connected to the jejunum, bypassing the duodenum.
3. Roux-en-Y gastrojejunostomy: A more complex procedure in which a portion of the jejunum is separated and reconnected further down the small intestine, creating a Y-shaped configuration. This type of gastroenterostomy is often used in bariatric surgery for weight loss.
The choice of gastroenterostomy technique depends on the specific medical condition being treated and the patient's overall health status.
The Schilling test is a medical procedure that was used to diagnose pernicious anemia and malabsorption of vitamin B12. The test measures the body's ability to absorb vitamin B12 from food or supplements.
In the test, the patient is given a small amount of radioactive vitamin B12 to swallow. After a set period of time, a urine sample is collected and measured for the amount of radioactivity present. If the body has properly absorbed the vitamin B12, it will be excreted in the urine.
If the test shows that the patient is not absorbing enough vitamin B12, they may have pernicious anemia or another condition that affects vitamin B12 absorption. The Schilling test has largely been replaced by other diagnostic tests, such as blood tests for anti-intrinsic factor antibodies and parietal cell antibodies.
List of MeSH codes (C23)
List of MeSH codes (C06)
List of syndromes
Hypothalamic-pituitary-thyroid axis
Gonadotropin-releasing hormone
Syncope (medicine)
Obstructed defecation
Neuromodulation (medicine)
Hypercapnia
Interstitial cystitis
Putamen
Visual pathway lesions
Gephyrin
Basal ganglia
Sensorineural hearing loss
Claustrum
Primate basal ganglia
Alien hand syndrome
Lithium (medication)
Vasopressin receptor
Zona incerta
Brain-computer interface
Brain natriuretic peptide 32
F wave
List of anatomy mnemonics
Mammalian kidney
5-HT3 antagonist
TRPM8
Perception
Procedural memory
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List of MeSH codes (C23) - Wikipedia
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Enter the afferent2
- Under gastrointestinal hormonal influence, up to 1-2 L of pancreatic and biliary secretions can enter the afferent loop each day. (medscape.com)
- We presume that the gallstone may enter the afferent jejunal loop through the hepaticojejunostomy and later increase in size. (ahbps.org)
Gastric7
- Passage of food and gastric secretions through the gastrojejunostomy and into the efferent loop triggers the release of secretin and cholecystokinin. (medscape.com)
- Gastric polyps, polyposis syndromes , and nonmucosal intramural tumors are treated surgically or endoscopically. (medscape.com)
- Various subtypes of gastric polyps are recognized and divided into nonneoplastic and neoplastic and are also further classified by their association with polyposis syndromes. (medscape.com)
- One of the presentations of gastric tumors is Gastric outlet obstruction which presents with biochemical and anatomicosurgical syndrome in these patients. (journalcra.com)
- We became interested to study the surgical outcome of laparoscopic hand sewn Roux En Y Gastrojejunostomy anastomosis in gastric outlet obstruction. (journalcra.com)
- 8 ESGE suggests that endoscopic ultrasound-directed transgastric ERCP (EDGE) can be offered, in expert centers, to patients with a Roux-en-Y gastric bypass following multidisciplinary decision-making, with the aim of overcoming the invasiveness of laparoscopy-assisted ERCP and the limitations of enteroscopy-assisted ERCP. (amsterdamumc.org)
- You are having a Roux-en-Y gastric bypass (RYGB). (umcno.org)
Arteriole1
- [3] Blood enters the glomerulus through the afferent arteriole at the vascular pole, undergoes filtration in the glomerular capillaries, and exits the glomerulus through the efferent arteriole at the vascular pole. (marlerblog.com)
Jejunal3
- The clinically relevant portion of the loop pertaining to ALS is the jejunal portion of the afferent limb. (medscape.com)
- ALS is caused by complete or partial mechanical obstruction at the gastrojejunostomy or at a point along the jejunal portion of the afferent loop. (medscape.com)
- The computed tomography (CT) scan led to a diagnosis of very rare type of gallstones ileus at the afferent jejunal loop. (ahbps.org)
Bowel9
- [ 1 ] High luminal pressures and distention increase bowel wall tension in the afferent loop (in accord with the Laplace law) and can lead to ischemia and gangrene with subsequent perforation and peritonitis. (medscape.com)
- On the next follow-up CT scan, the gallstone disappeared with mild distension of the afferent bowel loop, implicating spontaneous passage of the gallstone. (ahbps.org)
- Know as "the" gastrointestinal surgeon in Houston for three decades, Dr. Jordan treated patients with pancreatic cancer, short bowel syndrome, complex gastrointestinal malignancies, complex ulcer disease, and complex pancreatic problems. (bcm.edu)
- Does irritable bowel syndrome result from gravity? (news-medical.net)
- In a recent study published in the American Journal of Gastroenterology , the author proposed and discussed the hypothesis that irritable bowel syndrome (IBS) may result from gravity. (news-medical.net)
- It is used to restore bowel continuity after resection of a segment of the bowel or after creation of a Roux-en-Y loop of jejunum. (medscape.com)
- Images of a 38-year-old woman with Marfan syndrome who was diagnosed with intradural small bowel herniation through a torn right S1 dural ectasia. (auntminnie.com)
- B, C) T2-weighted MRI scans in (B) axial and (C) sagittal planes show the herniated loop (arrowheads in B) of small bowel (* in B) ascending at L5-S1 (arrows), causing significant compression of the adjacent cauda equina nerve roots. (auntminnie.com)
- Conditions that cause or require anatomic alterations include small-bowel diverticulosis, surgical blind loops, postgastrectomy states (especially in the afferent loop of a Billroth II), strictures, or partial obstruction. (msdmanuals.com)
Gastrojejunostomy6
- Afferent loop syndrome (ALS) is a purely mechanical complication that infrequently occurs following the construction of a gastrojejunostomy. (medscape.com)
- This limb of the intestine transfers bile, pancreatic juices, and other proximal intestinal secretions toward the gastrojejunostomy and is thus termed the afferent loop. (medscape.com)
- Kinking of the afferent limb at the gastrojejunostomy. (medscape.com)
- The afferent loop consists of the duodenal stump, the remainder of the duodenum, and the segment of jejunum proximal to the gastrojejunostomy. (medscape.com)
- An afferent loop is composed of the duodenal stump, the remainder of the duodenum, and the segment of jejunum located proximal to a Billroth II-type gastrojejunostomy. (medscape.com)
- The conclusion of the study was Laparoscopic Roux En Y Gastrojejunostomy is effective in achieving quality of life and the chances of afferent loop syndrome are least with it. (journalcra.com)
Bowman's1
- Bowman's capsule surrounds the glomerular capillary loops and participates in the filtration of blood from the glomerular capillaries. (marlerblog.com)
Sensory2
- The Hoffmann reflex, an involuntary reaction to electrical stimulation of muscle afferent sensory fibreswas studied, as was the long latency reflex (LLR) using the Dueschl method in which electrical stimulation is superimposed on a slight voluntary contraction, Different fatiguing protocols were performed, and respiratory rate continuously recorded. (daneurope.org)
- The main sensory nucleus receives its afferents (as the sensory root) from the semilunar ganglion through the lateral part of the pons ventral surface. (medscape.com)
Patients3
- The aims of the study were to assess the feasibility of the procedure and evaluate patients for Afferent Loop Syndrome post operatively. (journalcra.com)
- In general, all patients with hypercholesterolemia secondary to nephrotic syndrome should be treated with lipid-lowering agents because they are at increased risk for cardiovascular disease. (armandoh.org)
- In most patients with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), ingestion of water does not adequately suppress ADH, and the urine remains concentrated. (medilib.ir)
Partial obstruction1
- Secondarily, prolonged stasis and pooling of secretions with partial obstruction facilitate bacterial overgrowth in the afferent loop. (medscape.com)
Obstruction2
- Acute ALS represents complete obstruction of the afferent loop and is a true surgical emergency. (medscape.com)
- Closed-loop obstruction is suspected. (albionfoundation.org)
Symptoms4
- Symptoms associated with ALS are caused by increased intraluminal pressure and distention due to the accumulation of enteric secretions in a partially or completely obstructed afferent limb. (medscape.com)
- How To Remember Acrorenal Mandibular Syndrome Signs & Symptoms? (medicalsupernotes.com)
- Acrorenal mandibular syndrome can't be cured right now, so treatment is aimed at relieving symptoms and giving support. (medicalsupernotes.com)
- 3. Assess symptoms and differentiate between the 3 dysexecutive syndromes. (psychiatrictimes.com)
Passage1
- We herein present an extremely rare case of gallstone ileus, in whom the gallstone stone was formed at the hepaticojejunostomy and entrapped at afferent loop of the Roux-en-Y jejunojejunostomy, by which obstructive jaundice happened and resolved after spontaneous passage. (ahbps.org)
Procedure1
- He developed the Jordan test for afferent loop syndrome and the Jordan procedure for the treatment of complex pancreato-duodenal trauma. (bcm.edu)
Pancreatic1
- These enteric hormones stimulate the secretion of bile, pancreatic enzymes, and pancreatic bicarbonate and water into the afferent loop. (medscape.com)
Surgical1
- 7 ESGE recommends that EUS-GE may be considered in the management of afferent loop syndrome, especially in the setting of malignancy or in poor surgical candidates. (amsterdamumc.org)
Manifestation1
- Overview Nephrotic syndrome is a relatively rare but important manifestation of kidney disease. (armandoh.org)
Distal1
- In case of doubt, it is better not to anastomose but rather to exteriorize (loop stoma for a perforation and proximal stoma and distal mucus fistula after resection). (medscape.com)
Abdominal1
- Abdominal Cocoon Syndrome: a Rare Cause for Recurrent Abdominal Pain. (musc.edu)
Complication1
- Post-diarrheal hemolytic uremic syndrome (D+HUS) is a severe, life-threatening complication that occurs in about 10 percent of those infected with E. coli O157:H7 or other Shiga toxin-producing (Stx) E. coli (STEC). (marlerblog.com)
Acute1
- Acute hemolytic uremic syndrome (HUS). (marlerblog.com)
Treatment3
- See "Treatment of hyponatremia: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and reset osmostat" . (medilib.ir)
- See "Treatment of hyponatremia: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and reset osmostat", section on 'Intravenous hypertonic saline' . (medilib.ir)
- Urbano-Gámez JD, Benito I, Casañas JJ, Montesinos ML ( 2020 ) Prenatal treatment with rapamycin restores enhanced hippocampal mGluR-LTD and mushroom spine size in a Down's syndrome mouse model. (multichannelsystems.com)
Result1
- Dysexecutive syndromes result from damage to the anterior regions of the brain and present as a combination of disinhibition, disorganization, or apathy. (psychiatrictimes.com)
Kidney1
- Because this attachment causes these organs to be susceptible to the toxicity of Shiga toxins, this distribution explains the involvement of the gut, kidney, and brain in STEC-associated hemolytic uremic syndrome (HUS). (marlerblog.com)
Surgery1
- We herein present a very rare case of gallstone ileus inducing obstructive jaundice at the afferent loop of Roux-en-Y hepaticojejunostomy after 10 years of bile duct cancer surgery. (ahbps.org)
Rare1
- Acrorenal mandibular syndrome, also called Acrorenal mandibular field defect, is a rare genetic disorder that affects the ears, jaw, and kidneys, among other parts of the head and face. (medicalsupernotes.com)