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April 30, 2026The Japanese Journal of Gastroenterological Surgery0 citationsOpen Access

A Case of Afferent Loop Syndrome Caused by Hematoma Formation due to Anastomotic Bleeding after Laparoscopic Distal Gastrectomy for Gastric Cancer

TNTasuku NishitaniHYHideharu YamanakaCTChiharu Tamura

Key Points

  • To report a case of afferent loop syndrome caused by hematoma after laparoscopic distal gastrectomy for gastric cancer.
  • An 88-year-old male underwent laparoscopic distal gastrectomy with Roux-en-Y reconstruction for early gastric cancer.
  • Emergency endoscopy revealed hematoma at the anastomosis causing afferent loop syndrome.
  • Intervention involved endoscopic removal of the hematoma and clipping of the bleeding site.
  • Patient experienced abdominal distention and hematemesis two days post-surgery.
  • Endoscopic intervention improved dilation of the afferent loop.
  • Afferent loop syndrome was diagnosed due to anastomotic bleeding, leading to compression from hematoma.

Abstract

症例は88歳の男性で,早期胃癌に対し腹腔鏡下幽門側胃切除術(D1+郭清,Roux-en-Y再建)を施行した.手術8時間後に急性心筋梗塞を発症し冠動脈造影検査と経皮冠動脈インターベンションを施行した.術後2日目に腹部膨満と血性嘔吐を認めた.血液検査では貧血,単純CTで輸入脚に拡張を認めた.緊急内視鏡検査でY脚吻合部出血と吻合部から輸入脚にかけて血腫を認め,血腫による輸入脚症候群の診断となった.内視鏡的血腫除去と出血部のクリッピングにより輸入脚腸管の拡張は改善した.輸入脚症候群は胃切除後再建術に発症するまれな合併症で,内ヘルニア,吻合部狭窄,癒着,腫瘍が原因として多い.典型的には輸入脚の通過障害により,胆汁や膵液のうっ滞,腸管の拡張が引き起こされ,嘔吐や腹痛を呈する.腹腔鏡下幽門側胃切除術後に吻合部出血による血腫が形成され輸入脚を閉塞することで輸入脚症候群を発症した症例を経験したので報告する.

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Cite This Study

Nishitani et al. (2026) studied this question.

synapsesocial.com/papers/69f2f0e31e5f7920c6386edbhttps://doi.org/10.5833/jjgs.2025.0055
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