Afferent Loop Syndrome

輸入腸段徵候羣－病例報告及文獻回顧

林鴻章(H. C. Lin) ； 王賜洲(S. C. Wang) ； 潘漢生(H. S. Pan)

《Journal of Medical Sciences》 5卷4期 (1984/10) Pp. 2079-2084

摘要

於接受過次全胃切除及比洛氏貳號胃空腸吻合術患者中，發生急性輸入腸段徵候羣的病例雖不太多，但却是一個極嚴重的手術併發症。減低其死亡率之方法，在於早期症狀發生時即應考慮到，並且作正確而迅速的手術治療。既使實驗室檢查、X光檢查、加上近年來發展迅速的超音波、電腦斷層攝影檢查，都能提供一些依據，但是臨床之病史，症狀與徵候仍是不容忽視之診斷依據。本文旨在提供－胃切除及胃空腸吻合術後在輸入腸段發生扭轉而致阻塞之病例，從而回顧文獻來分析此徵候羣之發生率、病因、預防及癒後以供參考。

並列摘要

Afferent loop syndrome, a complication following subtotal gastrectomy with Billroth No.II anastomosis, though uncommon, carries high mortality. The problem lies in the fact that it is not easy to make an immediate and conclusive diagnosis. Great attention should be paid to clinical symotoms and signs, while the X ray, sonogram, C. T. scan and other laboratory investigations provide only limited help in making the diagnosis. The possible causes vary widely ranging from internal hernia, kink formation, to stenosis of the stoma. Many papers concerning the internal hernia which is believed to be the major cause of acute afferent loop syndrome had been presented by Stammer in 1952 and 1954. The case presented here, however, unassociated with internal hernia, is a case of afferent loop obstruction due to torsion above the ligment of Treitz nine days post operation. For a surgeon it is very important to keep this complication in mind after subtotal gastrectomy, so that early reoperation may be performed if acute afferent loop syndrome is suspected.

並列關鍵字

Afferent Loop Syndrome ； Hernia ； Stenosis