Yuan J, Zhang YJ, Wen W, Liu XC, Chen FL, Yang Y. Afferent loop syndrome of a patient with recurrent fever: A case report. World J Radiol 2024; 16(11): 678-682 [DOI: 10.4329/wjr.v16.i11.678]
Corresponding Author of This Article
Wu Wen, MD, Chief Physician, Department of Digestive Diseases, Chengdu Second People’s Hospital, No. 10 Qingyunan Street, Jinjiang District, Chengdu 610000, Sichuan Province, China. wenwu2@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Nov 28, 2024; 16(11): 678-682 Published online Nov 28, 2024. doi: 10.4329/wjr.v16.i11.678
Afferent loop syndrome of a patient with recurrent fever: A case report
Jing Yuan, Ying-Jie Zhang, Wu Wen, Xiao-Cong Liu, Feng-Lin Chen, Ye Yang
Jing Yuan, Department of Gastroenterology and Hepatology, Chengdu Second People’s Hospital, Chengdu 610017, Sichuan Province, China
Ying-Jie Zhang, Wu Wen, Department of Digestive Diseases, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
Xiao-Cong Liu, Department of Gastroenterology and Hepatology, Chengdu Second People's Hospital, Chengdu 610017, Sichuan Province, China
Feng-Lin Chen, Graduate School, Chengdu Medical College, Chengdu 610000, Sichuan Province, China
Ye Yang, Department of Digestive Diseases, Chengdu Qingbaijiang District People's Hospital, Chengdu 610300, Sichuan Province, China
Author contributions: Yuan J was responsible for the whole management of the patient and wrote the manuscript; Zhang YJ, Wen W led the operation of the patient; Liu XC directed the revision of the manuscript; Yang Y and Chen FL followed up the patient.
Informed consent statement: The patient and his family were forewarned that the patient's medical records will be included in the study and the publication of the manuscript, and the consent of the patients and their family was obtained.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4. 0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wu Wen, MD, Chief Physician, Department of Digestive Diseases, Chengdu Second People’s Hospital, No. 10 Qingyunan Street, Jinjiang District, Chengdu 610000, Sichuan Province, China. wenwu2@qq.com
Received: January 20, 2024 Revised: September 14, 2024 Accepted: October 23, 2024 Published online: November 28, 2024 Processing time: 312 Days and 5.4 Hours
Abstract
BACKGROUND
Afferent loop syndrome (ALS) is a rare complication, Aoki et al reported that the incidence of distal gastrectomy in Billroth-II is 0.3%-1.0%. The clinical manifestations of ALS are atypical, which can manifest as severe abdominal pain, vomiting, obstructive jaundice, malnutrition, etc.
CASE SUMMARY
The patient was a 58-year-old man who complained of recurrent high fever for more than 1 week. Laboratory tests showed an increase in neutrophil ratio, procalcitonin, C-reactive protein, and abnormal liver function. Enhanced computed tomography scan of the abdomen showed small intestinal obstruction between the anastomosis of the gastrojejunum, bile duct, and pancreaticoduodenum. Gastroscopy revealed significant narrowing of the lumen 15 cm from the anastomosis into the afferent loop. After performing balloon dilation and placement of the nutrition tube, the patient did not experience further fever.
CONCLUSION
ALS is relatively rare after pancreaticoduodenectomy, and the treatment depends on the nature of the obstructive lesion. The traditional treatment method is surgery, and in recent years, endoscopy has provided a new treatment method for ALS.
Core Tip: The manifestations of the afferent loop syndrome vary, and the patient we reported presented only with recurrent fever. Instead of surgery, we managed to relieve the patient's symptoms through endoscopic and minimally invasive interventions.
