Treatment of afferent loop syndrome using fluoroscopic-guided nasointestinal tube placement: Two case reports  

作　　者：Hai-Tao Hu Fu-Hai Ma Zhen-Min Wu Xiu-Heng Qi Yu-Xin Zhong Yi-Bin Xie Yan-Tao Tian 

机构地区：[1]Department of Pancreatic and Gastric Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China [2]Department of Oncology,Hebei Petro China Central Hospital,Langfang 065000,Hebei Province,China

出　　处：《World Journal of Clinical Cases》2020年第21期5353-5360,共8页世界临床病例杂志

基　　金：Supported by National Natural Science Foundation of China,No.81772642;Capital’s Funds for Health Improvement and Research,No.CFH2018-2-4022;Wu Jieping Medical Foundation,No.320.6750.15276.

摘　　要：BACKGROUND Afferent loop syndrome(ALS)is a rare mechanical complication that occurs after reconstruction of the stomach or esophagus to the jejunum,such as Billroth II gastrojejunostomy,Roux-en-Y gastrojejunostomy,or Roux-en-Y esophagojejunostomy.Traditionally,an operation is the first choice for benign causes.However,for patients in poor physical condition who experience ALS soon after R0 resection,the type of treatment remains controversial.Here,we present an efficient conservative method to treat ALS.CASE SUMMARY Case 1 was a 69-year-old male patient who underwent total gastrectomy with Roux-en-Y jejunojejunostomy.On postoperative day(POD)10 he developed symptoms of ALS that persisted and increased over 1 wk.Case 2 was a 59-yearold male patient who underwent distal gastrectomy with Billroth II gastrojejunostomy.On postoperative day POD 9 he developed symptoms of ALS that persisted for 2 wk.Both patients underwent fluoroscopic-guided nasointestinal tube placement with maintenance of continuous negative pressure suction.Approximately 20 d after the procedure,both patients had recovered well and were discharged from hospital after removal of the tube.At 3-mo follow-up,there were no signs of ALS in these two patients.CONCLUSION This is the first report of treating postoperative ALS by fluoroscopic-guided nasointestinal tube placement.Our cases demonstrate that this procedure is an effective and safe method to treat ALS that relieves patients’symptoms and avoids complications caused by other invasive procedures.

关 键 词：Afferent loop syndrome FLUOROSCOPY Nasointestinal tube Case report Rouxen-Y 

分 类 号：R656[医药卫生—外科学]