Electrohydraulic lithotripsy of an impacted enterolith causing acute afferent loop syndrome clinical endoscopy, vol. Afferent loop syndrome can occur anywhere from days to years after surgery. The other type of loop syndrome is afferent loop syndrome. Efferent loop syndrome is a very rare postgastrectomy syndrome that can.
Efferent loop syndrome in a postpancreatoduodenectomy. Afferent loop syndrome an overview sciencedirect topics. Difference between afferent and efferent arterioles compare. Efferent loop syndrome health encyclopedia university. Els can occur with reconstruction of the alimentary tract after a whipple procedure, billroth ii gastrectomy or rouxeny gastric bypass.
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. A problem with an anastomosis after gastrojejunostomy, such as an ulcer. Endoscopic treatment of efferent loop syndrome with. Afferent loop syndrome is a problem that can occur after some kinds of stomach surgery. When efferent loop syndrome happens, it is usually within the first few weeks after gastric bypass surgery. An obstruction of the afferent limb can present in various ways. Despite a difficult initial treatment phase, the patient is disease free and doing well after two and half years of completing treatment for the. If it occurs soon after surgery, its called acute afferent loop syndrome. The clear differentiation between the afferent loop syndrome als and the other postgastrectomy syndromes was made by hoffmann 3, who described the clinical picture as follows. 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 causes efferent loop syndrome after gastric surgery.
Afferent loop syndrome health encyclopedia university. In efferent loop syndrome, a portion or limb of the small intestine becomes blocked. Afferent limb syndromes have decreased in incidence with newer surgical techniques to decreass the size of the limb. What does afferent loop syndrome mean botcaster inc. Efferent loop syndrome is a very rare postgastrectomy syndrome that can occur following billrothii or rouxeny reconstruction. Afferent loop syndrome definition of 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. Afferent loop syndrome radiology reference article radiopaedia. However, in this case, efferent loop obstruction was successfully resolved by the insertion of a double pigtail stent. 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. In a loop syndrome, a portion or limb of the small intestine becomes blocked. Treatment by means of the placement of dual stents. This is a result from a complete blockage that commonly happens early after the surgical procedure and can be very dangerous unless prompt reoperation. 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. 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. Dec 28, 2008 the efferent limb extends downstream through the distal jejunum and on down towards the cecum. Know why a new medicine or treatment is prescribed, and how it will help you. Acute obstruction occurs within the first week after surgery. 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. Afferent loop syndrome is a mechanical bowel obstruction internal hernia, volvulus, stricturing, etc that results in an effective biliary outlet obstruction.
The efferent loop syndrome in a narrow sense refers only to obstruction of the efferent jejunal loop after gastric resection or simple gastroenterostomy. 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. Pdf laparoscopy in afferent loop obstruction presenting as. Afferent loop syndrome als is caused by mechanical obstruction of the afferent loop of a doublebarrel gastrojejunostomy a. For acute afferent loop syndrome, emergency surgery may be needed. Successful endoscopic management of efferent loop syndrome. The loop going to the upper stomach is the afferent loop. Afferent loop syndrome als is a purely mechanical complication that. The most common loop syndrome after gastric surgery is afferent loop syndrome.
These terms have a slightly different meaning in the context of the peripheral nervous system pns and central nervous system cns. 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. Afferent loop syndrome health encyclopedia university of. All aimed at helping you enjoy life by being aware of how to care for your health. Endoscopic treatment of efferent loop syndrome with insertion. The iatrogenic afferent loop syndrome, therefore, occurs more frequently with surgical construction of a partial stoma. Springer nature is making sarscov2 and covid19 research free. Afferent nerve fibers refer to axonal projections that arrive at a particular brain region, as opposed to efferent projections that exit the region.
Afferent definition of afferent by the free dictionary. In the following decades several authors were able clearly to demonstrate that bile reflux into the stomach causes vomiting. The treatment may involve medical therapy or surgery. Afferent loop syndrome is not an uncommon postoperative complication, and one study has estimated that it occurs in % of postpancreaticoduodenectomy patients 2. Efferent loop syndrome in a postpancreatoduodenectomy patient.
Anterograde jejunojejunal intussusception resulted in acute efferent loop syndrome after subtotal gastrectomy article pdf available in world journal of gastroenterology 1627. Surgeons have improved gastric surgery, so both types of loop syndromes are now less common. Afferent loop syndrome als is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. Efferent loop syndrome is one of two loop syndromes that can happen after. Als may be surgically corrected by deconstructing the billroth ii gastrojejunostomy and restoring gastrointestinal continuity with a rouxeny gastrojejunostomy b.
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. Afferent loop syndrome brigham and womens hospital. Acute als results from complete obstruction, usually occurs early after surgery and runs a devastatingly lethal course unless promptly treated by reoperation. Pdf afferent loop syndrome after rouxeny total gastrectomy. 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. Pdf anterograde jejunojejunal intussusception resulted. May 15, 2019 afferent loop syndrome als is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. The clear differentiation between the afferentloop syndrome als and the other.
Dec 07, 2017 an efferent arteriole is a part of the renal artery that carries filtered pure blood back to the circulatory system. Jan 17, 2016 what does afferent loop syndrome mean in english. 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. Afferent definition of afferent by medical dictionary. We report the successful treatment of a patient with efferent loop syndrome by implantation of a double pigtail stent. Afferent loop syndrome definition, symptoms, causes. 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. 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.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. The efferentloop syndrome in a narrow sense refers only to obstruction of the efferent jejunal loop after gastric resection or simple gastroenterostomy. Pdf afferent loop syndrome is a rare complication of gastric surgery. Afferent loop syndrome radiology reference article. Symptoms depend on which type of afferent loop syndrome is present. Followup gastrografin and endoscopic study showed free flow of contrast and recovery of narrowed, swollen orifice of the efferent loop d, e. Efferent loop syndrome is one of two loop syndromes that can happen after some types of gastric surgery. Stay up to date with the latest health news and useful resources. Afferent loop syndrome is an intermittent partial or complete mechanical.
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