Efferent Loop Syndrome
The efferent loop syndrome is a purely mechanical problem characterized by gastric outlet obstruction at or near the gastrojejunostomy. The etiology may be kinking or adhesions of the efferent limb, or internal herniation behind the gastroenterostomy. Symptoms include diffuse abdominal pain, nausea, and bilious vomiting. The syndrome may occur months to years after the operation. The diagnosis may be confirmed by contrast studies, which demonstrates obstruction of the efferent limb. Surgical therapy is usually required. The most common finding is an adhesive band obstructing the efferent limb near the gastric anastomosis (20). Correctional procedures may include revision of the anastomosis or conversion to a Billroth I or Roux-en-Y gastrojejunostomy.
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