Afferent loop syndrome (ALS) is a morbid complication that may occur after gastrectomy and gastrojejunostomy reconstruction. The aim of this article is to review the different endoscopic treatment options of ALS. We describe the evolution of the endoscopic treatment of ALS and its limitations despite the overall propitious profile. We analyze the advantages of endoscopic ultrasound-guided entero-enterostomy (EUS EE) over enteroscopy-guided intervention, and the clinical outcomes of EUS EE. We expound on pre-procedural considerations, intra-procedural techniques and post-procedural care following EUS EE. We conclude that given the simplification of the technique and the ability to place a stent away from the tumor, EUS EE is a promising technique that will likely be established as the treatment of choice for ALS.
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http://dx.doi.org/10.5009/gnl220205 | DOI Listing |
J Physiol
December 2024
Daniel Baugh Institute for Functional Genomics and Computational Biology, Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, PA, USA.
Loss of cardiac physiological function following myocardial infarction (MI) is accompanied by neural adaptations in the baroreflex that are compensatory in the short term, but then become associated with long-term disease progression. One marker of these adaptations is decreased baroreflex sensitivity, a strong predictor of post-MI mortality. The relative contributions of cardiac remodelling and neural adaptation in the sensory, central brainstem and peripheral ganglionic loci to baroreflex sensitivity changes remain underexplored.
View Article and Find Full Text PDFBrain Behav Immun
December 2024
Department of Anesthesia, Division of Pain Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Pediatric Pain Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, United States. Electronic address:
Neonatal pain is a significant clinical issue but the mechanisms by which pain is produced early in life are poorly understood. Our recent work has linked the transcription factor serum response factor downstream of local growth hormone (GH) signaling to incision-related hypersensitivity in neonates. However, it remains unclear if similar mechanisms contribute to inflammatory pain in neonates.
View Article and Find Full Text PDFJ Surg Case Rep
December 2024
Department of Surgery, Phramongkutklao Hospital, Thung Phaya Thai, Ratchathewi, Bangkok 10400, Thailand.
Endoscopic or fluoroscopic guided naso-enteric placement for stenting and decompression has been used in mechanical enteric limb obstruction after gastrectomy or gastric bypass surgery. However, the use of double naso-enteric tube for treatment of multiple enteric limbs obstruction has not been described to date. We present a 61-year-old female with afferent limb syndrome with concomitant efferent limb obstruction which caused by kinking of anastomosis after loop gastrojejunostomy for benign gastric outlet obstruction.
View Article and Find Full Text PDFWorld J Radiol
November 2024
Department of Digestive Diseases, Chengdu Qingbaijiang District People's Hospital, Chengdu 610300, Sichuan Province, China.
Background: Afferent loop syndrome (ALS) is a rare complication, Aoki reported that the incidence of distal gastrectomy in Billroth-II is 0.3%-1.0%.
View Article and Find Full Text PDFNature
December 2024
Faculty of Medicine, Department of Brain Sciences, Imperial College London, London, UK.
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