Title: The blind-loop syndrome after gastric operations.
Abstract: Since the earliest reports by White68 and Faber,19 it has been known that certain mechanical intestinal abnormalities could cause a hematologic syndrome which resembles pernicious anemia, and to date at least 100 examples have been reported. Location and etiology of the intestinal lesion varied, but the end result was stasis and retarded drainage from some portion of the gastrointestinal tract. Cases in which the stagnant loop was associated with certain specific absorption defects have been classified as examples of the blind-loop syndrome.6, 14, 26 It is probable that only a small number of patients with anatomic blind loops develop the blind-loop syndrome with its metabolically important changes.
Two of the most common operations performed today in which potential stagnant loops are created are Billroth II gastrectomy and gastroenterostomy. The duodenum is converted into a side arm which rejoins the main intestinal tract at the gastrojejunostomy. It is common knowledge that this afferent loop occasionally drains improperly.15, 30, 32, 37, 41, 42, 44, 46, 48, 53, 57, 58, 66, 67 However, prior to 1953, there were no well-documented reports of the blind-loop syndrome after either operation. Since that time, several examples of the blind-loop syndrome have been described after Billroth II resection or gastroenterostomy. The fact that only a handful of these cases has yet been reported may be due to the subtlety of the clinical manifestations, the difficulty of clearly establishing a diagnosis, and the general unawareness of this complication as a diagnostic possibility. In addition to its immediate clinical application, a consideration of the blind-loop syndrome may cast some light upon the nutritional superiority of the Billroth I over the Billroth II gastrectomy.
Publication Year: 1961
Publication Date: 1961-11-01
Language: en
Type: article
Indexed In: ['pubmed']
Access and Citation
Cited By Count: 24
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