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Diagnosis and treatment of the afferent loop syndrome

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Abstract

Afferent loop syndrome (ALS) is a mechanical complication that arises after gastric surgery with gastrojejunostomy reconstruction. This condition was first described in 1950 by Roux, Pedoussaut, and Marchal to post-gastrectomy patients with bilious vomiting. Acute ALS is associated with complete obstruction and considered a surgical emergency, whereas chronic ALS is mostly related to partial obstruction of the afferent loop. The delay in diagnosis may lead to intestinal ischemia, perforation and can be associated with a high mortality rate up to 60%. Surgery is usually the mainstay treatment of ALS, but endoscopic therapy, including stent placement in malignancy-related, anastomotic stricture dilation, has been evolving over the past recent years.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Panotpol Termsinsuk & Nonthalee Pausawasdi

  2. Division of Gastroenterology, Department of Internal Medicine, Rajavithi Hospital, Bangkok, Thailand

    Tanyaporn Chantarojanasiri

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  1. Panotpol Termsinsuk
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  2. Tanyaporn Chantarojanasiri
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Correspondence to Nonthalee Pausawasdi.

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Termsinsuk, P., Chantarojanasiri, T. & Pausawasdi, N. Diagnosis and treatment of the afferent loop syndrome. Clin J Gastroenterol 13, 660–668 (2020). https://doi.org/10.1007/s12328-020-01170-z

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