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Afferent loop syndrome is a complication of several different types of stomach surgery. If you have had or are going to have a procedure called gastrojejunostomy, you should know that afferent loop syndrome can occur after the surgery. Gastrojejunostomy is also also known as Billroth II gastrectomy procedure,.
During a Biliroth II type of operation, your surgeon will remove or bypass the lower part of your stomach and attach the remaining part of your stomach to a loop of intestine downstream. The area where your stomach and intestine attach is called the anastomosis. The intestine downstream from the anastomosis is called the efferent limb.
After surgery, your bile and pancreatic digestive juices enter the afferent loop. All these juices flow downstream and need to pass through the anastomosis and enter your digestive system. Afferent loop syndrome occurs when something traps the flow of these juices up to and past the anastomosis.
Following are common causes of afferent loop syndrome:
Symptoms will start to appear when the secretions from your pancreas and bile fill the afferent loop and are unable to pass through the anastomosis. The secretions build up in the afferent limb. This causes pressure, especially after a meal. Afferent loop syndrome can occur anywhere from days to years after surgery. Afferent loop syndrome that occurs soon after surgery—within the first few weeks—is called acute afferent loop syndrome. This usually means the afferent loop is completely obstructed. Afferent loop syndrome that occurs weeks, or even years, after surgery is called chronic afferent loop syndrome. This usually means there is a partial obstruction.
The most common symptoms are:
Your health care provider may suspect afferent loop syndrome if you have symptoms any time after gastrojejunostomy surgery. Although blood tests and basic X-rays can help with the diagnosis, the best test is a CT scan. This will show the fluid-filled, swollen afferent loop. Another test you may get is an upper GI endoscopy. This will show obstruction of the afferent limb.
Treatment is almost always surgery. In acute afferent loop syndrome, emergency surgery may be necessary to prevent rupture of the loop. The type of surgery will depend on what's causing the actual obstruction. In some cases, the anastomosis may need to be taken apart and redone. If the afferent loop has become scarred and narrowed, it may need to be removed.
To better understand the complications of gastrectomy surgery, ask your doctor to explain all the risks and benefits of the surgery before your procedure. After surgery, carefully follow your medical team's instructions. And always call your doctor right away if you have any symptoms that could indicate afferent loop syndrome.
Tips to help you get the most from a visit to your health care provider:
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