Yuan Jing, Zhang Ying-Jie, Wen Wu, Liu Xiao-Cong, Chen Feng-Lin, Yang Ye
Department of Gastroenterology and Hepatology, Chengdu Second People's Hospital, Chengdu 610017, Sichuan Province, China.
Department of Digestive Diseases, Chengdu Second People's Hospital, Chengdu 610000, Sichuan Province, China.
World J Radiol. 2024 Nov 28;16(11):678-682. doi: 10.4329/wjr.v16.i11.678.
Afferent loop syndrome (ALS) is a rare complication, Aoki reported that the incidence of distal gastrectomy in Billroth-II is 0.3%-1.0%. The clinical manifestations of ALS are atypical, which can manifest as severe abdominal pain, vomiting, obstructive jaundice, malnutrition,
The patient was a 58-year-old man who complained of recurrent high fever for more than 1 week. Laboratory tests showed an increase in neutrophil ratio, procalcitonin, C-reactive protein, and abnormal liver function. Enhanced computed tomography scan of the abdomen showed small intestinal obstruction between the anastomosis of the gastrojejunum, bile duct, and pancreaticoduodenum. Gastroscopy revealed significant narrowing of the lumen 15 cm from the anastomosis into the afferent loop. After performing balloon dilation and placement of the nutrition tube, the patient did not experience further fever.
ALS is relatively rare after pancreaticoduodenectomy, and the treatment depends on the nature of the obstructive lesion. The traditional treatment method is surgery, and in recent years, endoscopy has provided a new treatment method for ALS.
输入袢综合征（ALS）是一种罕见的并发症，青木报道毕Ⅱ式远端胃切除术后其发生率为0.3%-1.0%。ALS的临床表现不典型，可表现为严重腹痛、呕吐、梗阻性黄疸、营养不良。
患者为一名58岁男性，主诉反复高热1周余。实验室检查显示中性粒细胞比例、降钙素原、C反应蛋白升高，肝功能异常。腹部增强计算机断层扫描显示胃空肠吻合口、胆管和胰十二指肠之间存在小肠梗阻。胃镜检查显示从吻合口进入输入袢15 cm处管腔明显狭窄。在进行球囊扩张并放置营养管后，患者未再发热。
胰十二指肠切除术后ALS相对少见，治疗取决于梗阻性病变的性质。传统治疗方法是手术，近年来，内镜检查为ALS提供了一种新的治疗方法。
