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Efferent Loop Syndrome

What is efferent loop syndrome?

Efferent loop syndrome is one of two "loop syndromes" that can occur after some types of gastric surgery. In a loop syndrome, a portion or "limb" of the small intestine becomes blocked.

Of the two types of loop syndromes, the other type, afferent loop syndrome, is the more common. Efferent loop syndrome is quite rare. Surgeons have improved gastric surgery, so both types of loop syndromes are now less common.

What causes efferent loop syndrome after gastric surgery?

The blockage in efferent loop syndrome can happen because of a hernia within the small intestine, which becomes trapped and blocked. It can also happen because of blockage from an adhesive band or kinking because of scarring or poor reconstruction during the weight-loss surgery. In some cases, part of your intestine may slide inside another part of the intestine (called intussusceptions), causing an efferent loop blockage.

What are the symptoms of efferent loop syndrome after gastric surgery?

When efferent loop syndrome occurs, it is usually within the first few weeks after surgery. But it can also develop even years after weight-loss surgery.

As a result of the blockage, secretions such as bile and other secretions from the pancreas build up in the intestines and begin to cause problems. Rarely, a rupture of the intestinal wall can occur.

You may have the following symptoms:

  • Extreme, often cramping, abdominal pain
  • Nausea
  • Distended abdomen and pain relieved only by vomiting
  • Vomiting large quantities of bile, a green digestive fluid

How is efferent loop syndrome diagnosed?

If your doctor suspects that you have efferent loop syndrome as a result of a gastric bypass procedure, he or she may perform a physical exam, upper gastrointestinal X-ray, or a CT scan to look for the blockage. Doctors will generally use an endoscope, a thin, lighted tube with a tiny camera at the end, passed through your mouth and into your intestines to confirm the diagnosis.

How is efferent loop syndrome treated?

Surgery is required to correct efferent loop syndrome and restore the intestines to healthy working order. Depending on how severe the efferent loop syndrome has become, the surgery may have to repair lesions, fix a hernia, close any anatomical defects, repair the intestine, and possibly make changes or repairs to the gastric surgery itself.

When should I call my health care provider?

Contact your doctor immediately if you have any symptoms of efferent loop syndrome any time after your weight-loss surgery.

Key points

In efferent loop syndrome, a portion or "limb" of the small intestine becomes blocked. Efferent loop syndrome is quite rare.

  • When efferent loop syndrome occurs, it is usually within the first few weeks after surgery.
  • Common symptoms are:
    • Extreme, often cramping, abdominal pain
    • Nausea
    • Distended abdomen and pain relieved only by vomiting
    • Vomiting large quantities of bile, a green digestive fluid
  • Doctors will generally use an endoscope passed through your mouth and into your intestines to confirm the diagnosis.
  • Surgery is required to correct efferent loop syndrome.
  • Contact your doctor immediately if you have any of these symptoms any time after your weight-loss surgery.



Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Online Medical Reviewer: Fincannon, Joy, RN, MN
Online Medical Reviewer: newMentor board-certified, academically affiliated clinician
Last Review Date: 12/26/2013
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