DIAGNOSIS AND TREATMENT OF AFFERENT LOOP OBSTRUCTION

Abstract

Post-gasterectomy obstraction of the afferent loop is a serious disease where sudden abdominal pain occurs once complete occlusion develops, and unless appropriate surgical measures are taken early, the condition leads to dilatation, perforation, and necrosis of the afferent loop, with a fatal outcome. In this paper we investigated the pathology and clinical features of this disease to discuss its problems in 13 cases experienced at the hospital and 72 domestic cases which could be seen in the literature. In resconstructive procedures for the initial operations. Billroth-II in a portion anterior to the colon was most commonly employed in a frequency of 68.3%. Limiting to our experience with cases undergoing gastrectomy, these 4 cases represented 1.0% of Billroth-II cases, these 2 cases represented 0.68% of total gastrectomy cases. Preoprative correct diagnosis rate was a low 34.1%, where ultrasonography and CT were usful. Death cases were more frequently noted in those of which diagnosis and teratment were delayed after the onset of the disease. The important life-saving measure is early diagnosis after the onset. If abdominal pain occurs after gastrectomy, it is necessary to keep in mind the probable presence of this disease.