Using Multidetector-Row CT for the Diagnosis of Afferent Loop Syndrome Following Gastroenterostomy Reconstruction.
10.3349/ymj.2011.52.4.574
- Author:
Yu Hsiu JUAN
1
;
Chih Yung YU
;
Hsian He HSU
;
Guo Shu HUANG
;
De Chuan CHAN
;
Chang Hsien LIU
;
Ho Jui TUNG
;
Wei Chou CHANG
Author Information
1. Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan. weichou.chang@gmail.com
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Afferent loop syndrome;
multidetector-row CT;
Roux-en-Y gastroenterotomy;
Billroth II gastrojejunostomy;
Whipple's operation
- MeSH:
Adult;
Afferent Loop Syndrome/*radiography;
Aged;
Aged, 80 and over;
Female;
Gastroenterostomy/*adverse effects;
Humans;
Male;
Middle Aged;
Retrospective Studies;
Tomography, X-Ray Computed/*methods
- From:Yonsei Medical Journal
2011;52(4):574-580
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To assess the clinical manifestations and multidetector-row computed tomography (MDCT) findings of afferent loop syndrome (ALS) and to determine the role of MDCT on treatment decisions. MATERIALS AND METHODS: From January 2004 to December 2008, 1,100 patients had undergone gastroenterostomy reconstruction in our institution. Of these, 22 (2%) patients were diagnosed as ALS after surgery that included Roux-en-Y gastroenterotomy (n=9), Billroth-II gastrojejunostomy (n=7), and Whipple's operation (n=6). Clinical manifestations and MDCT features of these patients were recorded and statistically analyzed. The presumed etiologies of obstruction shown on the MDCT were correlated with clinical information and confirmed by surgery or endoscopic biopsy. RESULTS: The most common clinical symptom was acute abdominal pain, presenting in 18 patients (82%). We found that a fluid-filled C-shaped afferent loop in combination with valvulae conniventes projecting into the lumen was the most common MDCT features of ALS. Malignant causes of ALS, such as local recurrence and carcinomatosis, are the most common etiologies of obstruction. These etiologies and associated complications can be predicted 100% by MDCT. CONCLUSION: Our results suggest that MDCT is a reliable modality for assessing the etiologies of ALS and guiding treatment decisions.
