Stay up to date with the latest health news and useful resources. The patient underwent reexploration just three weeks later for efferent loop syndrome, the cause of which was again found to be a mass due to fbgcr that was not previously present. Difference between afferent and efferent arterioles compare. Efferent loop syndrome is a very rare postgastrectomy syndrome that can occur following billrothii or rouxeny reconstruction. Afferent loop syndrome health encyclopedia university. The loop going to the upper stomach is the afferent loop. Afferent loop syndrome is not an uncommon postoperative complication, and one study has estimated that it occurs in % of postpancreaticoduodenectomy patients 2. Afferent loop syndrome als is a purely mechanical complication that infrequently occurs following the construction of a gastrojejunostomy. The efferent loop syndrome in a narrow sense refers only to obstruction of the efferent jejunal loop after gastric resection or simple gastroenterostomy. Causes of afferent loop syndrome include a kinking and angulation of the afferent limb, b internal herniation of the afferent limb behind the efferent limb, c stenosis of the gastrojejunal anastomosis, d redundancy of the afferent limb leading to volvulus, or e adhesions involving the afferent limb. If it occurs soon after surgery, its called acute afferent loop syndrome. Afferent loop syndrome als is a purely mechanical complication that. The most common loop syndrome after gastric surgery is afferent loop syndrome. Despite a difficult initial treatment phase, the patient is disease free and doing well after two and half years of completing treatment for the.
Efferent loop syndrome is one of two loop syndromes. Efferent loop syndrome els is a rare complication defined as mechanical obstruction of the efferent enteric jejunal limb causing symptoms such as epigastric pain and massive bilious vomiting. The other type of loop syndrome is afferent loop syndrome. Despite a difficult initial treatment phase, the patient is disease free and doing well after two and half years of completing treatment for the carcinoma gallbladder.
The afferent loop syndromes result from obstruction to the afferent jejunal loop. Als may be surgically corrected by deconstructing the billroth ii gastrojejunostomy and restoring gastrointestinal continuity with a rouxeny gastrojejunostomy b. Endoscopic treatment of efferent loop syndrome with. Afferent loop syndrome definition, symptoms, causes. Afferent loop syndrome is an intermittent partial or complete mechanical obstruction of the afferent limb of a gastrojejunostomy the syndrome classically refers to obstruction of the upstream limb of a sidetoside gastrojejunostomy but has also been used to refer to the biliopancreatic limb of a rouxeny gastrojejunostomy. Afferent loop syndrome is an intermittent partial or complete mechanical. Dec 28, 2008 the efferent limb extends downstream through the distal jejunum and on down towards the cecum.
In a loop syndrome, part of the small intestine becomes blocked. Dec 07, 2017 an efferent arteriole is a part of the renal artery that carries filtered pure blood back to the circulatory system. However, in this case, efferent loop obstruction was successfully resolved by the insertion of a double pigtail stent. Afferent definition of afferent by medical dictionary. Els can occur with reconstruction of the alimentary tract after a whipple procedure, billroth ii gastrectomy or rouxeny gastric bypass. Endoscopic treatment of efferent loop syndrome with insertion. The iatrogenic afferent loop syndrome, therefore, occurs more frequently with surgical construction of a partial stoma. Pdf afferent loop syndrome is a rare complication of gastric surgery. Followup gastrografin and endoscopic study showed free flow of contrast and recovery of narrowed, swollen orifice of the efferent loop d, e. The loop carrying food away from the stomach is called the efferent loop. Springer nature is making sarscov2 and covid19 research free. We report the successful treatment of a patient with efferent loop syndrome by implantation of a double pigtail stent. Afferent loop syndrome is a problem that can occur after some kinds of stomach surgery.
The efferentloop syndrome in a narrow sense refers only to obstruction of the efferent jejunal loop after gastric resection or simple gastroenterostomy. May 15, 2019 afferent loop syndrome als is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. Afferent limb syndromes have decreased in incidence with newer surgical techniques to decreass the size of the limb. When efferent loop syndrome happens, it is usually within the first few weeks after gastric bypass surgery. Efferent loop syndrome in a postpancreatoduodenectomy. Afferent definition of afferent by the free dictionary. Afferent loop syndrome als is caused by mechanical obstruction of the afferent loop of a doublebarrel gastrojejunostomy a. Acute als results from complete obstruction, usually occurs early after surgery and runs a devastatingly lethal course unless promptly treated by reoperation. This is a result from a complete blockage that commonly happens early after the surgical procedure and can be very dangerous unless prompt reoperation. Jan 17, 2016 what does afferent loop syndrome mean in english. Efferent loop syndrome in a postpancreatoduodenectomy patient. The key difference between afferent and efferent arterioles is, the afferent arterioles bring the impure blood to the glomerulus whereas the efferent arterioles take away the pure filtered blood back to the circulatory system. Efferent loop syndrome health encyclopedia university. Electrohydraulic lithotripsy of an impacted enterolith causing acute afferent loop syndrome clinical endoscopy, vol.
Surgeons have improved gastric surgery, so both types of loop syndromes are now less common. Acute obstruction occurs within the first week after surgery. Afferent loop syndrome can occur anywhere from days to years after surgery. Afferent loop syndrome radiology reference article. Efferent loop syndrome is one of two loop syndromes that can happen after.
Afferent loop syndrome brigham and womens hospital. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Afferent loop syndrome health encyclopedia university of. Pdf afferent loop syndrome after rouxeny total gastrectomy. All aimed at helping you enjoy life by being aware of how to care for your health. Anterograde jejunojejunal intussusception resulted in acute efferent loop syndrome after subtotal gastrectomy article pdf available in world journal of gastroenterology 1627. Blind loop syndrome bls, also known as stagnant loop syndrome, is a state that occurs when the normal bacterial flora of the small intestine proliferates to numbers that cause significant derangement to the normal physiological processes of digestion and absorption. Afferent loop syndrome als is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. For acute afferent loop syndrome, emergency surgery may be needed. Know why a new medicine or treatment is prescribed, and how it will help you. 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. The clear differentiation between the afferentloop syndrome als and the other. Afferent loop syndrome definition of afferent loop syndrome.
What causes efferent loop syndrome after gastric surgery. Symptoms depend on which type of afferent loop syndrome is present. Afferent loop syndrome an overview sciencedirect topics. Pdf anterograde jejunojejunal intussusception resulted. Successful endoscopic management of efferent loop syndrome. If your healthcare provider thinks you have efferent loop syndrome because of gastric bypass surgery, he or she may do a physical exam, upper gastrointestinal xray, or a ct scan to look for the blockage.
Carrying inward to a central organ or section, as nerves that conduct impulses from the periphery of the body to the brain or spinal cord. Efferent loop syndrome health encyclopedia university of. Pdf laparoscopy in afferent loop obstruction presenting as. Creation of an anastomosis between the stomach and jejunum leaves a segment of the small bowel, most commonly consisting of the duodenum and proximal jejunum, lying upstream from the gastrojejunostomy. What does afferent loop syndrome mean botcaster inc. Afferent nerve fibers refer to axonal projections that arrive at a particular brain region, as opposed to efferent projections that exit the region. Efferent loop syndrome is a very rare postgastrectomy syndrome that can. Afferent loop sydrome common after bilroth ii is characterized by post prandial ruq pain, bilious vomiting, anemia, steatorrhea, and pain which resolves suddenly after decompression. These terms have a slightly different meaning in the context of the peripheral nervous system pns and central nervous system cns. Afferent loop syndrome radiology reference article radiopaedia. Afferent loop syndrome is a mechanical bowel obstruction internal hernia, volvulus, stricturing, etc that results in an effective biliary outlet obstruction. A restricted stoma with partial closure of the cut end of the stomach hofmeister facilitates gastric emptying into that segment of jejunum attached to the greater curvature figs. Endoscopic stent procedure was performed that doublepigtail stent was inserted through efferent loop stenosis and over the guide wire using doublechannel endoscope under endoscopic view c.
The treatment may involve medical therapy or surgery. Efferent loop syndrome is one of two loop syndromes that can happen after some types of gastric surgery. Creation of an anastomosis between the stomach and jejunum leaves a segment of small bowel, most commonly consisting of duodenum and proximal jejunum, lying upstream from the gastrojejunostomy. Treatment by means of the placement of dual stents. In a loop syndrome, a portion or limb of the small intestine becomes blocked. Followup gastrograpin and endoscopic study showed free flow of. An obstruction of the afferent limb can present in various ways. In efferent loop syndrome, a portion or limb of the small intestine becomes blocked. In the following decades several authors were able clearly to demonstrate that bile reflux into the stomach causes vomiting. A problem with an anastomosis after gastrojejunostomy, such as an ulcer.
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