All India Institute of Medical Sciences, Rishikesh India.
Ann R Coll Surg Engl. 2022 Nov;104(9):e252-e254. doi: 10.1308/rcsann.2022.0009. Epub 2022 Apr 21.
Afferent loop syndrome (ALS) is an uncommon complication of gastrojejunostomy. It may be acute or chronic depending on whether symptoms manifest within 7 days of surgery. Rarely acute ALS may give rise to acute pancreatitis. It may present early in the postoperative course and, if diagnosed late, may result in organ failure within 48h. We report a middle-aged woman with carcinoma of the stomach managed by subtotal gastrectomy with Billroth II gastrojejunostomy and Braun jejunojejunostomy. The patient developed vomiting and abdominal pain in the first postoperative day with acute renal shutdown and about 500ml drain output of dirty fluid. On investigation, a diagnosis of acute pancreatitis due to afferent loop syndrome was made, and the patient was resuscitated in the intensive care unit. However, she showed early signs of organ failure and succumbed to her condition within 6 days of surgery. Since the complication is rare following gastrojejunostomy and often mimics ALS, an early diagnosis becomes difficult. If delay in management happens, premature organ failure may lead to high morbidity and mortality.
Afferent loop syndrome (ALS) is an uncommon complication of gastrojejunostomy. It may be acute or chronic depending on whether symptoms manifest within 7 days of surgery. Rarely acute ALS may give rise to acute pancreatitis. It may present early in the postoperative course and, if diagnosed late, may result in organ failure within 48h. We report a middle-aged woman with carcinoma of the stomach managed by subtotal gastrectomy with Billroth II gastrojejunostomy and Braun jejunojejunostomy. The patient developed vomiting and abdominal pain in the first postoperative day with acute renal shutdown and about 500ml drain output of dirty fluid. On investigation, a diagnosis of acute pancreatitis due to afferent loop syndrome was made, and the patient was resuscitated in the intensive care unit. However, she showed early signs of organ failure and succumbed to her condition within 6 days of surgery. Since the complication is rare following gastrojejunostomy and often mimics ALS, an early diagnosis becomes difficult. If delay in management happens, premature organ failure may lead to high morbidity and mortality.
Afferent loop syndrome (ALS) 是胃空肠吻合术后的一种不常见并发症。根据症状是否在手术后 7 天内出现，它可能是急性的或慢性的。很少见的急性 ALS 可能导致急性胰腺炎。它可能在术后早期出现，如果诊断较晚，可能在 48 小时内导致器官衰竭。我们报告了一例中年女性，患有胃癌，行胃大部切除术，Billroth II 式胃空肠吻合术和 Braun 空肠空肠吻合术。患者在术后第一天出现呕吐和腹痛，伴有急性肾功能衰竭和约 500ml 脏液体引流。经调查，诊断为因输入袢综合征引起的急性胰腺炎，患者在重症监护病房进行复苏。然而，她在术后 6 天内出现早期器官衰竭迹象，并因此去世。由于该并发症在胃空肠吻合术后很少见，并且常常类似于 ALS，因此早期诊断变得困难。如果管理延迟，早期器官衰竭可能导致高发病率和死亡率。
输入的英文文本为：Afferent loop syndrome (ALS) 是胃空肠吻合术后的一种不常见并发症。根据症状是否在手术后 7 天内出现，它可能是急性的或慢性的。很少见的急性 ALS 可能导致急性胰腺炎。它可能在术后早期出现，如果诊断较晚，可能在 48 小时内导致器官衰竭。我们报告了一例中年女性，患有胃癌，行胃大部切除术，Billroth II 式胃空肠吻合术和 Braun 空肠空肠吻合术。患者在术后第一天出现呕吐和腹痛，伴有急性肾功能衰竭和约 500ml 脏液体引流。经调查，诊断为因输入袢综合征引起的急性胰腺炎，患者在重症监护病房进行复苏。然而，她在术后 6 天内出现早期器官衰竭迹象，并因此去世。由于该并发症在胃空肠吻合术后很少见，并且常常类似于 ALS，因此早期诊断变得困难。如果管理延迟，早期器官衰竭可能导致高发病率和死亡率。
