Carcinoma of Gastric Stump Complicating Afferent Loop Obstruction and Perforation Simulating Acute Pancreatitis

以急性胰臟炎來表現的殘胃癌引發之輸入環症候群

劉家彣(Jai-Wen Liu) ； 詹毓哲(Yu-Tse Tsan) ； 朱振國(Chen-Kuo Chu) ； 張群岳(Chun-Yueh Chang) ； 王立敏(Lee-Min Wang)

《Journal of Emergency Medicine, Taiwan》 9卷2期 (2007/06) Pp. 56-59

摘要

輸入環症候群是罕見切除術後胃吻合術之併發症。在急診室易因診斷為單純急性胰臟炎，而忽略了緊急手術的需要。我們報告一例輸入環症候群於接口處胃側因殘胃癌造成阻塞，並有穿孔與腹膜炎。病人於20年前因消化性潰瘍接受部份胃切除併胃空腸吻合術。輸入環症候群的症狀、機轉、造成急性胰臟炎機轉與殘胃癌問題將討論之。

關鍵字

輸入環症候群 ； 殘胃癌 ； 部份胃切除術 ； 胃空腸吻合術 ； 急性胰臟炎

並列摘要

Afferent loop syndrome is an uncommon complication of gastroenterostomy reconstruction after gastrectomy and is easily mistaken for simple acute pancreatitis without urgent surgical indication. We report a case of gastric stump carcinoma complicating afferent loop syndrome and perforation who presented to the Emergency Department with acute pancreatitis. The patient had received partial gastrectomy with Billroth-Ⅱ anastomosis 20 years ago for peptic ulcer. The etiologies of afferent loop syndrome, pathogenesis of acute pancreatitis and the problem of gastric stump carcinoma are discussed.

並列關鍵字

afferent loop syndrome ； gastric stump cancer ； partial gastrectomy ； Billroth anastomosis ； acute pancreatitis