Blind loop perforation after side-to-side ileocolonic anastomosis

Abstract

Blind loop syndrome after side-to-side ileocolonic anastomosis is a well-recognized entity even though its incidence and complication rates are not clearly defined. The inevitable dilation of the ileal cul-de-sac leads to stasis and bacterial overgrowth which eventually leads to mucosal ulceration and even full-thickness perforation. Blind loop syndrome may be an underestimated complication in the setting of digestive surgery. It should always be taken into account in cases of acute abdomen in patients who previously underwent right hemicolectomy. We herein report 3 patients who were diagnosed with perforative blind loop syndrome a few years after standard right hemicolectomy followed by a side-to-side ileocolonic anastomosis.

Keywords: Blind loop syndrome; Blind loop pouch; Perforation; Ileocolonic anastomosis; Laparoscopy

Core tip: The authors suggest that we are likely to see more and more cases of blind loop syndrome in the future because more side-to-side ileocolonic anastomoses will be performed in the setting of colonic laparoscopic surgery. A blind loop perforation should immediately be investigated in a patient who presents with acute abdomen years after a right hemicolectomy. Ideally, more end-to-end anastomoses should be performed, whenever suitable, in an effort to prevent the development of a blind loop.