"AFFERENT LOOP SYNDROME"之電腦斷層造影徵象

CT Appearance of "Afferent Loop Syndrome"

源金好(Kam-Ho Yuen) ； 潘慧本(Huay-Ben Pan) ； 蘇友吉(Y. G. Su) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 10卷2期 (1985/06) Pp. 156-160

摘要

自民國71年至73年間，共經驗了8例afferent loop syndrome。其中男性5例，女性3例。年齡從35歲到78歲。8例皆經胃部份切除與Billroth第二型胃迴吻合術的病史，從開刀後到發生afferent loop obstruotion(ALO)的時間，最短4天，最長達24年。幾乎所有病例皆因急性腹部症狀（上腹疼痛、嘔吐、惡心等）而接受電腦斷層檢查。5例會作術前血清澱粉酶濃度測定，結果皆超過正常值。因其在電腦斷層上可直接看見低密度囊狀的腸管，排例於上腹部兩側，上腸系膜動脈被向前推移，冠狀面影像重組(coronal reoonstruction)更可見U形膨脹的近端腸管。此點，可與症狀類似的單純急性胰臟炎(uncomplicated acute pancreatitis)及胰臟假性囊腫(pseudocyst of pancreas)相區分而得到準確診斷。目前國內尚無此類報告，故提出此8例經驗，並探求其血清澱粉酶上升的意義。

並列摘要

Eight patients of Afferent Loop Syndrome had performed CT examination during the past three years. Seven had operative proved and one received conservative treatment 1ecause of rectal metastasis due to carcinoma of the stomach. They all had the past history of subtotal gastrectomy and BII anastomosis due to variable causes. The amylase level was abnormally high in five cases. The main symptom was acute abdominal pain. The interval between operation and onset of symptom was about 4 days up to twenty four years. The CT pattern showed two or multiple cystic structure with thin bowel wall associated with internal fluid content located behind SMA which could be easily identified in CT. The characteristic U-shaped figure on reconstruction image made it rapidly differentiate from the similar manifestation of acute panreatitis with pseudocyst formation. To our knowledge this is the first report of CT appearance of ”Afferent Loop Syndrome” in our country.