Síndrome da alça aferente com necrose simulando pseudocisto de pâncreas
Afferent loop obstruction after gastrectomy and Billroth II reconstruction is an uncommon problem. Complete acute obstruction requires emergent laparotomy. We describe a patient who developed acute abdominal pain, hyperamylasemia, and palpable abdominal mass, five years after Billroth II gastrectomy...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgiões
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| Series: | Revista do Colégio Brasileiro de Cirurgiões |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69911998000200013&lng=en&tlng=en |
| _version_ | 1818969406308352000 |
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| author | Gerson Alves Pereira Omar Féres José Ivan de Andrade Reginaldo Ceneviva |
| author_facet | Gerson Alves Pereira Omar Féres José Ivan de Andrade Reginaldo Ceneviva |
| author_sort | Gerson Alves Pereira |
| collection | DOAJ |
| description | Afferent loop obstruction after gastrectomy and Billroth II reconstruction is an uncommon problem. Complete acute obstruction requires emergent laparotomy. We describe a patient who developed acute abdominal pain, hyperamylasemia, and palpable abdominal mass, five years after Billroth II gastrectomy. At laparotomy the patient was found to have a complete stricture of the afferent limb with evidence of strangulation and necrosis. There was no evidence of pancreatitis or pancreatic pseudocyst. The patient underwent pancreaticoduodenectomy plus degastrectomy and died 18 hours after the procedure in the ICU. The mass was initially inte1preted as pancreatic pseudocyst. Ultrasonography may provide enough evidence to differentiate a pancreatic pseudocyst. from an obstructed afferent loop, by the presence of a peripancreatic cystic mass or debris within the mass or the absence of the keyboard sign, suggesting effacement of the valvulae conniventes of the small bowel. Howewer, CT scan of the abdomen has been suggested to be highly characteristic, if not pathognomonic, for an obstructed afferent loop and should be considered first in patients with pancreatitis after Billroth II gastrectomy. A history of previous gastrectomy, recurrent or severe abdominal pain, hyperamylasemia with characteristic tomography, and endoscopic findings will establish the diagnosis and necessitate surgical evaluation and intervention. |
| first_indexed | 2024-12-20T14:20:05Z |
| format | Article |
| id | doaj.art-792d3270422542e9be244fbdbe7d9849 |
| institution | Directory Open Access Journal |
| issn | 1809-4546 |
| language | English |
| last_indexed | 2024-12-20T14:20:05Z |
| publisher | Colégio Brasileiro de Cirurgiões |
| record_format | Article |
| series | Revista do Colégio Brasileiro de Cirurgiões |
| spelling | doaj.art-792d3270422542e9be244fbdbe7d98492022-12-21T19:37:56ZengColégio Brasileiro de CirurgiõesRevista do Colégio Brasileiro de Cirurgiões1809-454625213814010.1590/S0100-69911998000200013S0100-69911998000200013Síndrome da alça aferente com necrose simulando pseudocisto de pâncreasGerson Alves Pereira0Omar Féres1José Ivan de Andrade2Reginaldo Ceneviva3Universidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloAfferent loop obstruction after gastrectomy and Billroth II reconstruction is an uncommon problem. Complete acute obstruction requires emergent laparotomy. We describe a patient who developed acute abdominal pain, hyperamylasemia, and palpable abdominal mass, five years after Billroth II gastrectomy. At laparotomy the patient was found to have a complete stricture of the afferent limb with evidence of strangulation and necrosis. There was no evidence of pancreatitis or pancreatic pseudocyst. The patient underwent pancreaticoduodenectomy plus degastrectomy and died 18 hours after the procedure in the ICU. The mass was initially inte1preted as pancreatic pseudocyst. Ultrasonography may provide enough evidence to differentiate a pancreatic pseudocyst. from an obstructed afferent loop, by the presence of a peripancreatic cystic mass or debris within the mass or the absence of the keyboard sign, suggesting effacement of the valvulae conniventes of the small bowel. Howewer, CT scan of the abdomen has been suggested to be highly characteristic, if not pathognomonic, for an obstructed afferent loop and should be considered first in patients with pancreatitis after Billroth II gastrectomy. A history of previous gastrectomy, recurrent or severe abdominal pain, hyperamylasemia with characteristic tomography, and endoscopic findings will establish the diagnosis and necessitate surgical evaluation and intervention.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69911998000200013&lng=en&tlng=enAfferent loop obstructionPancreatitis |
| spellingShingle | Gerson Alves Pereira Omar Féres José Ivan de Andrade Reginaldo Ceneviva Síndrome da alça aferente com necrose simulando pseudocisto de pâncreas Revista do Colégio Brasileiro de Cirurgiões Afferent loop obstruction Pancreatitis |
| title | Síndrome da alça aferente com necrose simulando pseudocisto de pâncreas |
| title_full | Síndrome da alça aferente com necrose simulando pseudocisto de pâncreas |
| title_fullStr | Síndrome da alça aferente com necrose simulando pseudocisto de pâncreas |
| title_full_unstemmed | Síndrome da alça aferente com necrose simulando pseudocisto de pâncreas |
| title_short | Síndrome da alça aferente com necrose simulando pseudocisto de pâncreas |
| title_sort | sindrome da alca aferente com necrose simulando pseudocisto de pancreas |
| topic | Afferent loop obstruction Pancreatitis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69911998000200013&lng=en&tlng=en |
| work_keys_str_mv | AT gersonalvespereira sindromedaalcaaferentecomnecrosesimulandopseudocistodepancreas AT omarferes sindromedaalcaaferentecomnecrosesimulandopseudocistodepancreas AT joseivandeandrade sindromedaalcaaferentecomnecrosesimulandopseudocistodepancreas AT reginaldoceneviva sindromedaalcaaferentecomnecrosesimulandopseudocistodepancreas |