Summary afferent vs efferent arterioles the nephron is the functional unit of the kidney, and the major function ultrafiltration of the kidney is mainly carrying out by nephrons. Abdominal computed tomography scan revealed dilation of the duodenum and small intestine. This document was downloaded for personal use only. Know why a new medicine or treatment is prescribed, and how it will help you. Bidirectional gastrojejunal emptying is more easily accomplished if the entire cut end of the stomach polya is used for anastomosis fig. Acute als results from complete obstruction, usually occurs early after surgery and runs a devastatingly lethal course unless promptly treated by reoperation. Antecolic reconstruction, antiperistaltic gastrojejunostomy, and poor positioning of the gastrojejunostomy along the greater curve of the stomach are also risk factors in development of the syndrome and should be considered when. A double pigtail stent should be considered a treatment option for relieving efferent loop obstruction if immediate surgical treatment is not required. In a loop syndrome, a portion or limb of the small intestine becomes blocked. Afferent loop syndrome after rouxeny total gastrectomy. Complications such as obstruction or dysfunction of the efferent jejunal loop, dumping. Afferent loop syndrome health encyclopedia university of. Fluid pressure builds up in the afferent loop and causes discomfort and nausea. Carrying impulses from the central nervous system to an effector.
Endoscopic treatment of efferent loop syndrome with insertion of. Foreign body giant cell reactions fbgcr also rarely develop into masses that are large enough to cause problems or mimic malignancy. Afferent nerve fibers refer to axonal projections that arrive at a particular brain region, as opposed to efferent projections that exit the region. Management strategy of afferent loop obstruction alo depends on. Efferent loop syndrome in a postpancreatoduodenectomy. The other type of loop syndrome is afferent loop syndrome. The efferent limb extends downstream through the distal jejunum and on down towards the cecum. These terms have a slightly different meaning in the context of the peripheral nervous system pns and central nervous system cns in the pns, afferent and efferent projections are always from the perspective of the spinal cord see figures. The iatrogenic afferent loop syndrome, therefore, occurs more frequently with surgical construction of a partial stoma.
Pdf anterograde jejunojejunal intussusception resulted in. Afferent loop syndrome is a rare complication of gastric surgery. The clear differentiation between the afferentloop syndrome als and the other postgastrectomy syndromes was made by hoffmann 3, who described the clinical picture as follows. Afferent loop syndrome is associated with long afferent loops generally 30 cm in length, which can also present with diarrhea, marginal ulcer, or malabsorption. Efferent loop syndrome in a postpancreatoduodenectomy patient. Stay up to date with the latest health news and useful resources. The major cause of syndrome is an intestinal hernia. Afferent loop syndrome after rouxeny total gastrectomy caused. In those cases that have been reported, the majority presented late and recurrence or peritoneal metastases were found to be the usual causes. Blind loop syndrome bls is a state that occurs when the normal bacterial flora of the small intestine proliferates to numbers that cause significant derangement to the normal physiological processes of digestion and absorption. The treatment consists of surgical relief of the obstruction. Jan 17, 2016 what does afferent loop syndrome mean in english. Efferent loop syndrome has been rarely reported after pancreatoduodenectomy.
Choose from 361 different sets of afferent efferent pathway flashcards on quizlet. Alo caused by a benign lesion needs definitive repair of the primary cause by surgery. Surgeons have improved gastric surgery, so both types of. A 73yearold man presented with one day of persistent abdominal pain, gradually radiating to the back. Treatment of afferent loop syndrome depends on the etiology. The loop carrying food away from the stomach is called the efferent loop. During the procedure, a surgeon will remove or bypass the lower part of the stomach and attach the remaining upper part of the stomach to a loop of small. Afferent limb syndrome als is a wellrecognized delayed adverse event after subtotal gastrectomies and other gastrojejunostomies. When efferent loop syndrome happens, it is usually within the first few weeks after gastric bypass surgery. Endoscopic treatment of efferent loop syndrome with. If the pressure builds up, the bile and pancreatic fluid may then empty into the upper stomach. All aimed at helping you enjoy life by being aware of how to care for your health. Carrying inward to a central organ or section, as nerves that conduct impulses from the periphery of the body to the brain or spinal cord. Efferent loop syndrome is a very rare postgastrectomy.
These terms have a slightly different meaning in the context of the peripheral nervous system pns and central nervous system cns. Afferent loop syndrome is a mechanical bowel obstruction internal hernia, volvulus, stricturing, etc that results in an effective biliary outlet obstruction. Afferent loop syndrome radiology reference article. Singlestep eusguided jejunojejunostomy with a lumen. Afferent loop syndrome can occur after some types of gastrojejunostomy. Afferent loop syndrome definition of afferent loop. Als is defined as a chronic, mechanical obstruction of the afferent limb al, resulting in pancreatobiliary problems. Case histories of 2 successfully treated patients are presented. Etiologi entrapment or compression of the afferent. Creation of an anastomosis between the stomach and jejunum leaves a segment of small bowel, most commonly consisting of duodenum and proximal jejunum, lying upstream from the gastrojejunostomy. Afferent or efferent loop syndrome is a purely mechanical problem characterized by the obstruction of gastric emptying at or near the site of a gastrojejunostomy.
Despite a difficult initial treatment phase, the patient is disease free and doing well after two and half years of completing treatment for the. Nov 07, 20 afferent loop syndrome is commonly reported, while efferent loop syndrome is very rarely reported. Afferent loop syndrome als is a purely mechanical complication that infrequently occurs following the construction of a gastrojejunostomy. Afferent loop syndrome als is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. Anterograde jejunojejunal intussusception resulted in acute efferent loop syndrome after subtotal gastrectomy. Afferent loop syndrome definition, symptoms, causes. Blind loop syndrome bls, also known as stagnant loop syndrome, is a state that occurs when the normal bacterial flora of the small intestine proliferates to numbers that cause significant derangement to the normal physiological processes of digestion and absorption.
The retention of secretions within the afferent loop gives rise to some symptoms very similar to the efferent loop syndrome. He had a history of total gastrectomy with a rouxeny reconstruction. The iatrogenic afferentloop syndrome, therefore, occurs more frequently with surgical construction of a partial stoma. In the chronic syndrome, shortening of the afferent loop to 1015 cm or conversion to either billroth i or rouxeny gastrojejunostomy will treat the condition. They possess the cellular machinery to achieve two fundamental physiological mechanisms of the nervous system. Afferent loop syndrome is an uncommon complication following surgical procedures such as billroth ii gastrojejunostomy, and it occurs in approximately 0. Afferent loop syndrome occurs when something traps the flow of these juices in the afferent loop. Complications such as obstruction or dysfunction of the efferent jejunal loop, dumping syndrome, and to some extent, nutritional. Signs and symptoms of these two complications may be similar and difficult to distinguish. In some cases of blind loop syndrome, overgrowth of pathogenic non commensal bacteria has also been noted. It results from obstruction of the afferent loop at any site and is caused by a variety of postoperative complications, such as recurrent tumor, adhesion, and kinking.
Successful endoscopic management of efferent loop syndrome. The renal artery provides blood to the glomerulus which is to be filtered. The efferentloop syndrome in a narrow sense refers only to obstruction of the efferent jejunal loop after gastric resection or simple gastroenterostomy. Alo caused by a malignant lesion needs palliative treatment percutaneous and endoscopic interventions, bypass surgery or excision. Loop syndrome batasan sindroma akibat obstruksi mekanik lengkap atau parsial pada titik di sepanjang bagian jejunum loop aferen atau eferen post gastrojejunostomy komplikasi murni mekanis akibat tindakan gastrojejunostomy yang jarang terjadi tanda dan gejala dari kedua komplikasi sulit dibedakan. The afferent loop syndromes result from obstruction to the afferent jejunal loop. Acute pancreatitis and hepatic necrosis in the acute afferent loop syndrome. Endoscopic management of afferent loop syndrome of malignant. We present a patient who had early efferent loop obstruction after gastrectomy due to a retained drain. Afferent loop sydrome common after bilroth ii is characterized by post prandial ruq pain, bilious vomiting, anemia, steatorrhea, and pain which resolve. Efferent loop obstruction is a rare complication after gastrectomy and most literatures discuss on the commoner complication of afferent loop syndrome. For example, an artery is an efferent vessel that carries blood away from the heart, and an efferent nerve carries impulses away from the central nervous system. Efferent loop syndrome is one of two loop syndromes that can happen after. Efferent loop syndrome health encyclopedia university of.
May 15, 2019 afferent loop syndrome als is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. Difference between afferent and efferent arterioles. However, the efferent loop was still unobstructed figure 2. Obstruction of the afferent loop after partial gastrectomy with billroth ii gastrojejunal anastomosis results in the afferent loop syndrome. In efferent loop syndrome, a portion or limb of the small intestine becomes blocked. The signs and symptomes of both loop syndromes may be similar and difficult to distinguish, and surgical treatment is usually required to correct these problems. During the procedure, a surgeon will remove or bypass the lower part of the stomach and attach the remaining upper part of the stomach to a loop of small intestine.
The excessive fullness after even a small meal, the nausea, and the anorexia are not due to the quot small stomach quot but to increased intestinal activity. Afferent loop syndrome which is also known as afferent limb syndrome is a complication caused by a stomach surgery specifically following billroth ii gastrectomy procedure. Efferent definition of efferent by the free dictionary. Efferent loop syndrome is one of two loop syndromes that can happen after some types of. Creation of an anastomosis between the stomach and jejunum leaves a segment of the small bowel, most commonly consisting of the duodenum and proximal jejunum, lying upstream from the gastrojejunostomy. The nephron is composed of renal corpuscle having capillaries known as glomerulus and encompassing structure called as bowmans capsule. Efferent loop syndrome is one of two loop syndromes that can happen after some types of gastric surgery.
Efferent loop syndrome els is a rare complication defined as mechanical obstruction of the efferent enteric jejunal limb causing symptoms such as epigastric pain and massive bilious vomiting. Treatment by means of the placement of dual stents. Endoscopic treatment of efferent loop syndrome with insertion. Efferent loop syndrome health encyclopedia university. Afferent loop syndrome definition of afferent loop syndrome. Afferent loop syndrome health encyclopedia university. The various methods used to reestablish gastroenteric continuity after subtotal gastrectomy still do not totally obviate unpleasant complications and sequelae. Els can occur with reconstruction of the alimentary tract after a whipple procedure, billroth ii gastrectomy or rouxeny gastric bypass.
Pdf afferent loop syndrome after rouxeny total gastrectomy. Afferent loop syndrome an overview sciencedirect topics. In a loop syndrome, part of the small intestine becomes blocked. In some cases of blind loop syndrome, overgrowth of pathogenic noncommensal bacteria has also been noted. Without pain, and usually in the morning after getting up or some time after. Efferent nerve motor motor nerve carrys response from brain or spinal cord to body for appropriate action. In average, there are about 15,000 mechanical receptor cells in each human cochlea, and ohcs constitute three quarters of them. If a person had or is about to have this procedure, one must be aware that afferent syndrome can possibly occur after the stomach surgery.
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