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Create a Free AccountAnatomy - Small intestine
Percutaneous- and EUS-guided gastroenterostomy for malignant afferent limb syndrome
Malignant afferent limb syndrome (ALS) is a rare adverse event that can occur after pancreaticoduodenectomy. Patients can be seen with a range of clinical conditions, including obstructive jaundice, cholangitis, nonbilious vomiting, and acute abdominal pain.1 Patients with malignant ALS are often poor surgical candidates.1 Endoscopic decompression provides a safe and effective alternative to surgical bypass. Here, we report a unique case of malignant ALS, in which we used a pre-existing internal/external biliary drain to assist in creating an EUS-guided gastroenterostomy.Single-step EUS-guided jejunojejunostomy with a lumen-apposing metal stent as treatment for malignant afferent limb syndrome
Afferent limb syndrome (ALS) is a well-recognized delayed adverse event after subtotal gastrectomies and other gastrojejunostomies. ALS is defined as a chronic, mechanical obstruction of the afferent limb (AL), resulting in pancreatobiliary problems. It is more common in long-term survivors (≥2 years) who have undergone pancreaticoduodenectomy (PD) for cancer and adjuvant chemoradiation.1 In fact, among those patients, ALS is more likely to occur because of the long period of time for the radiation effects and cancer recurrence to develop.
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