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Sonographic diagnosis of obstructed afferent loop
L E Derchi1, M Bazzocchi, P L Brovero
1Istituto di Radiologia, Università di Genova, Italy.
Gastrointestinal Radiology
|January 1, 1992
Summary
Sonography can identify afferent loop obstruction in gastric stump tumors after Billroth II surgery. Recognizing the distended loop and its course is crucial for diagnosing this postsurgical complication.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Oncology
Background:
- Afferent loop obstruction is a potential complication following partial gastrectomy with gastrojejunostomy.
- Tumors of the gastric stump can lead to afferent loop obstruction.
- Sonography is a primary imaging modality for abdominal complaints.
Purpose of the Study:
- To describe the sonographic findings in patients with afferent loop obstruction secondary to gastric stump tumors.
- To highlight the importance of recognizing postsurgical gastrointestinal anatomy on ultrasound.
Main Methods:
- Retrospective review of sonographic findings in four patients.
- Correlation of imaging findings with clinical and surgical data.
Main Results:
- The obstructed afferent loop was consistently visualized as a distended, fluid-filled segment with a multi-layered wall.
- The loop's course from the hepatic hilum to the gastric stump was traceable.
- In two cases, anatomical relationships confirmed the structure as the postoperative duodenum.
- Gastric remnant thickening and obstructive jaundice were noted in three patients.
Conclusions:
- Sonography is effective in visualizing the characteristic features of afferent loop obstruction in this context.
- Familiarity with postsurgical sonographic appearances is vital for accurate diagnosis of complications like afferent loop obstruction.