Acute afferent loop syndrome: a true emergency. A case report
K D Ballas1, S E Rafailidis, H D Konstantinidis
1Aristotle's University of Thessaloniki, 2nd Prop. Department of Surgery, Thessaloniki, Greece.
Acta Chirurgica Belgica
|April 4, 2009
Summary
Afferent loop syndrome, a rare complication of subtotal gastrectomy, can present decades later. Early CT diagnosis and surgical intervention are crucial for this uncommon condition.
Area of Science:
- Gastroenterology
- Surgical Complications
Background:
- Subtotal gastrectomy, particularly Billroth II with Roux-Y reconstruction, can lead to rare complications.
- Afferent loop syndrome is an uncommon delayed complication following these procedures.
Observation:
- A 60-year-old male presented with acute epigastric pain, vomiting, fever, and sepsis 27 years after a Billroth II gastrectomy.
- Laboratory findings included leukocytosis, elevated liver function tests, and high serum amylase.
- CT scan revealed a fluid-filled, obstructed afferent loop and signs of advanced sepsis.
Findings:
- The patient underwent immediate surgery for Roux-Y anastomosis reconstruction.
- Despite prompt intervention, the patient died 12 hours post-operatively due to advanced sepsis.
Implications:
- Afferent loop syndrome, though uncommon, should be suspected in post-gastrectomy patients presenting with non-specific symptoms.
- Computed Tomography (CT) is the diagnostic modality of choice.
- Surgical intervention remains the primary treatment, necessitating timely diagnosis and management.
Related Concept Videos
01:30Introduction Cardiac Emergencies
Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
01:30Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
01:18Disorders of the Autonomic Nervous System
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's phenomenon, is a...
Raynaud's disease, also known as Raynaud's phenomenon, is a...
01:30Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...