Case Of Afferent Loop Obstruction Research Articles

Percutaneous Transhepatic Bowel Stent Deployment: An Alternative Approach for Malignant Afferent Loop Obstruction Following Whipple’s Procedure

Afferent loop syndrome is an uncommon postoperative complication. Currently, we lack a therapeutic option for treatment of malignant afferent loop obstruction following procedures like Whipple's. Here we present a case of afferent loop obstruction in a known case of pancreatic carcinoma, status after Whipple’s procedure, in which we used a percutaneous transhepatic approach to relieve the afferent loop obstruction using a self-expanding bare metal stent.

A Case of afferent loop obstruction caused by torsion and strangulation after total gastrectomy with Roux-en-Y reconstruction

A Case of afferent loop obstruction caused by torsion and strangulation after total gastrectomy with Roux-en-Y reconstruction

A Case of Afferent Loop Syndrome Treated by Endoscopic Metal Stent Insertion Using Two Endoscopes

들창자 증후군의 ë¹„ìˆ˜ìˆ ì  치료 방법은 다양하지만 ì–¸ì œë‚˜ ëª¨ë“ ë°©ë²•ì´ 다 ì ìš© 가능한 것은 아니다. 특히 ë‚´ì‹œê²½ì  치료 방법은 í•´ë¶€í•™ì  변형으로 인해 병변으로의 ì ‘ê·¼ì— ì œí•œì ì´ 있다. 이에 ì €ìžë“¤ì€ ì• ì„± ì¢ ì–‘ìœ¼ë¡œ 인한 들창자 증후군 환자에서 2개의 내시경을 이용하여 ì„±ê³µì ìœ¼ë¡œ ê¸ˆì†ìŠ¤í íŠ¸ë¥¼ ì‚½ìž í•œ 사례를 문헌 ê³ ì°°ê³¼ 함께 ë³´ê³ í•˜ëŠ” 바이다. 중심 단어: 들창자증후군; ì·Œì‹­ì´ì§€ìž¥ì ˆì œìˆ ; 췌장암; 내시경

経皮経肝胆道ドレナージを用いて保存的に治癒した輸入脚閉塞症の1例

経皮経肝胆道ドレナージを用いて保存的に治癒した輸入脚閉塞症の1例

内視鏡的バルーン拡張術で治癒したY脚吻合部狭窄による輸入脚閉塞症の1例

症例は71歳の女性で，胃癌に対する開腹幽門側胃切除術，Roux-en-Y再建（Roux-en-Y脚は21mm径のCircular staplerを用いた端側吻合）の4カ月後に，腹痛・嘔気・食欲不振を主訴に来院した．腹部CTでRoux-Y脚吻合部のstaplerから十二指腸断端までの輸入脚が著明に拡張していたため，吻合部狭窄による輸入脚閉塞症と診断した．緊急の上部消化管内視鏡検査を施行したところ，門歯から60cmの空腸にpin holeの狭窄部位を認めた．バルーン拡張術を施行すると，輸入脚より大量の胆汁の流出を認めた．術後経過は良好で，術後第9病日に退院した．Roux-Y脚の吻合部狭窄による輸入脚閉塞症に対して，内視鏡的バルーン拡張術は非侵襲的で有用な治療法と考えられた．

胃切除後に内ヘルニアが原因で輸入脚閉塞症を呈した1例

胃切除後に内ヘルニアが原因で輸入脚閉塞症を呈した1例

A Case of Afferent Loop Obstruction after Distal Gastrectomy with Billroth II Reconstruction : A Case Report and Review of Literature

A Case of Afferent Loop Obstruction after Distal Gastrectomy with Billroth II Reconstruction : A Case Report and Review of Literature

左半結腸切除術後に生じた輸入脚閉塞症に対し保存的治療が有効であった1例

左半結腸切除術後に生じた輸入脚閉塞症に対し保存的治療が有効であった1例

経皮経腸ドレナージが有効であった輸入脚閉塞症の１例

経皮経腸ドレナージが有効であった輸入脚閉塞症の１例

A CASE OF AFFERENT LOOP OBSTRUCTION DUE TO INVASION OF CARCINOMA OF THE TRANSVERSE COLON

A case of afferent loop obstruction due to invasion of carcinoma of the transverse colon is reported. A 69-year-old man was admitted to the hospital because of fever, abdominal pain and nausea. There was a previous history of undergoing a Billroth II antecolic gastrectomy for gastric ulcer 25 years before admission. He was diagnosed as having an advanced carcinoma of the transverse colon by a total colonoscopy and Ba-enema study. The temperature rose to 39°C suddenly, and the laboratory studies revealed leukocytosis and an elevation in CRP level. Ultrasonography and computed tomography revealed a large cystic mass adjacent to the pancreas head and a diagnosis of obstruction of the afferent loop was made. Endoscopic drainage of the afferent loop was attempted but failed. Therefore, an emergency operation was performed on the same day and the obstructed afferent loop was drainaged. Thirteen days after the drainage, he underwent a radical operation for the transverse colon carcinoma. However, he died of carcinomatous peritonitis and multiple lung metastasis 2 months after the operation. Afferent loop obstruction is a complication following gastrectomy, though it is rare. The most common causes of obstruction are internal hernia, adhesion, and flexion. According to the literature, only 2 cases of obstruction of afferent loop due to invasion of colonic carcinoma including our case have been reported in Japan.

AFFERNT LOOP OBSTRUCTION WITH DUODENAL PERFORATION

Afferent loop obstruction is a complication following gastrectomy, though it is rare. Afferent loop obstruction with duodenal perforation is further associated with liver dysfunction, pancreatitis, and retroperitoneal abscess, when its prognosis is poor. So we define this condition as severe afferent loop obstruction and try to apply more appropriate treatment as possible as we can. Recently we experienced a patient with afferent loop obstruction with duodenal perforation 25 years after a gas trectomy whose life was successfully saved by intensive treatment. An 84-year-old woman developed duodenal perforation, hemorrhage from the anterior superior pancreatoduodenal artery, and repeatedly recurrent retroperitoneal abscess after the operation. We aggressively performed angiography, bdominal ultrasonography, and abdominal CT again and again for the early detection of the abscess; and successfully saved the patient with aggressive drainage and embolization. In a recent 12-year period a series of 16 cases of afferent loop obstruction have been treated at the hospital. These cases are also reviewed in this paper.

Two Cases of Afferent loop Obstruction Following Gastrectomy

Two Cases of Afferent loop Obstruction Following Gastrectomy

CT appearance of afferent loop obstruction.

Obstruction of the afferent loop may develop in patients who have had a Billroth type II gastrojejunostomy. This obstructed loop has a characteristic but initially confusing computed tomographic appearance that might be mistaken for multiple peripancreatic cystic masses. Three cases of afferent loop obstruction due to gastric carcinoma are reported. In each case, the length of the jejunal segment incorporated into the afferent loop determined the number of cystic masses evident at each scan level. Recognition of the typical anatomic configuration and uniform size of these cystic masses is key to the correct diagnosis.

A further case of afferent loop obstruction simulating acute pancreatitis.

A further case of afferent loop obstruction simulating acute pancreatitis.

A Further Case of Afferent Loop Obstruction Simulating Acute Pancreatitis^;

A Further Case of Afferent Loop Obstruction Simulating Acute Pancreatitis^;