1. [Acute pancreatitis and afferent loop syndrome. Case report].
- Author
-
Barajas-Fregoso EM, Romero-Hernández T, and Macías-Amezcua MD
- Subjects
- Abdominal Pain etiology, Acute Disease, Adenocarcinoma surgery, Afferent Loop Syndrome diagnosis, Afferent Loop Syndrome diagnostic imaging, Afferent Loop Syndrome therapy, Aged, Analgesics therapeutic use, Anastomosis, Roux-en-Y adverse effects, Cholecystectomy, Combined Modality Therapy, Fasting, Gastrectomy methods, Humans, Jejunum surgery, Male, Pancreatitis blood, Pancreatitis therapy, Postgastrectomy Syndromes diagnosis, Postgastrectomy Syndromes diagnostic imaging, Postgastrectomy Syndromes therapy, Stomach Neoplasms surgery, Symptom Assessment, Tomography, X-Ray Computed, Vomiting etiology, Water-Electrolyte Balance, Afferent Loop Syndrome etiology, Gastrectomy adverse effects, Pancreatitis etiology, Postgastrectomy Syndromes etiology
- Abstract
Background: The afferent syndrome loop is a mechanic obstruction of the afferent limb before a Billroth II or Roux-Y reconstruction, secondary in most of case to distal or subtotal gastrectomy. Clinical case: Male 76 years old, with antecedent of cholecystectomy, gastric adenocarcinoma six years ago, with subtotal gastrectomy and Roux-Y reconstruction. Beginning a several abdominal pain, nausea and vomiting, abdominal distension, without peritoneal irritation sings. Amylase 1246 U/L, lipase 3381 U/L. Computed Tomography with thickness wall and dilatation of afferent loop, pancreas with diffuse enlargement diagnostic of acute pancreatitis secondary an afferent loop syndrome., Conclusion: The afferent loop syndrome is presented in 0.3%-1% in all cases with Billroth II reconstruction, with a mortality of up to 57%, the obstruction lead accumulation of bile, pancreatic and intestinal secretions, increasing the pressure and resulting in afferent limb, bile conduct and Wirsung conduct dilatation, triggering an inflammatory response that culminates in pancreatic inflammation. The severity of the presentation is related to the degree and duration of the blockage.
- Published
- 2013