stagnant loop syndrome


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A complication of Billroth II subtotal gastroenterostomy—end-to-side enteroenteric anastomosis—that may arise long after surgery; the afferent loop consists of duodenum and a variable portion of jejunum, a loop that is a temporary reservoir for 1–1.5 litres of biliary and pancreatic secretions; after a fatty meal, the contents of a partially obstructed afferent loop increase and ‘explosively’ enter the stomach and may be regurgitated as greenish bilious fluid; other symptoms include intermittent diarrhoea due to disaccharidase deficiency, abdominal ‘colic’, haemorrhage, vitamin deficiency and neurologic symptoms; with prolonged partial obstruction, the stool is steatorrhoeic—bulky, grey, and greasy—accompanied by weight loss; complete blind loop obstruction may be a medical emergency with rapid deterioration, shock, and perforation peritonitis
Management Antibiotics—e.g., T-S—loop shortening, afferent-to-efferent or Roux-en-Y anastomoses or gastrojejunostomy

stagnant loop syndrome

Blind loop syndrome, see there.