Treatment of Afferent Loop Syndrome with Benign Intraluminal Obstruction due to Phytobezoar or Enterolith
Afferent loop syndrome can occur when the afferent limb is obstructed by a benign intraluminal mass — either a phytobezoar or an enterolith lodged within the loop. This page summarises the clinical scenario and directs to the complete structured management protocol.
Clinical scenario
A phytobezoar migrating into the afferent loop can cause intraluminal obstruction. Separately, enteral stasis within the afferent loop promotes bacterial overgrowth, which leads to bile salt precipitation and enterolith formation — enteroliths may then produce afferent loop obstruction in their own right.
Management approach
The primary intervention for relieving benign intraluminal obstruction in this setting is endoscopic — aimed at achieving clearance of the obstructing material from the afferent loop. The specific technique selection and full procedural algorithm are detailed in the complete protocol →
Treatment goal: Fragmentation and clearance of the obstructing material from the afferent loop, with relief of afferent loop obstruction.
References
DOI: 10.5009/gnl220205
- Migration of the phytobezoar into the afferent loop may result in obstruction.
- Enteral stasis causes bacterial overgrowth and leads to bile salt precipitation, resulting in enterolith formation and afferent loop obstruction.
- This obstruction can be relieved by endoscopic retrieval of the phytobezoar using a snare or retrieval net, or by fragmentation–either mechanically or by using electrohydraulic lithotripsy.
- Both endoscopic basket retrieval and endoscopic electrohydraulic lithotripsy are effective means in removing enteroliths.
- Technical success was excellent, with phytobezoar fragmentation and clearance in 100% of patients.
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