Afferent loop obstruction following gastrectomy is a rare but fatal complication. Clinical features of afferent loop obstruction are mainly gastrointestinal symptoms. A 56-year-old female underwent radical total gastrectomy with Roux-en-Y esophagojejunostomy for treatment of advanced gastric cancer. After fourteen months postoperatively, she showed gradual development of edema of both legs. Computed tomography (CT) scan showed disease progression at the jejunojejunostomy site and consequent dilated afferent loop, which resulted in inferior vena cava (IVC) compression. A drainage catheter was placed percutaneously into the afferent loop through the intrahepatic duct and an IVC filter was placed at the suprarenal IVC, and selfexpanding metal stents were inserted into bilateral common iliac veins. With these procedures, sympotms related with afferent loop obstruction and deep vein thrombosis were improved dramatically. The follow-up abdominal CT scan was taken 3 weeks later and revealed the completely decompressed afferent loop and improved IVC patency. Surgical treatment should be considered as the first choice for afferent loop obstruction; however, because it is more immediate and less invasive, non-surgical modalities, such as percutaneous catheter drainage or stent placement, can be effective alternatives for inoperable cases or risky patients who have severe medical comorbidities.
An experimental study was performed to investigate. The subjects drank 0.5g/kg ethanol and performed 7 items of SPES(simple reaction time, color word stress, digit classification, finger tapping speed, numerical ability, symbol digit coding, memory digit span). 20 students of medical college participated in the study during August, 1996. After ethanol intake, performance of 4 items(simple reaction time, digit classification, finger tapping speed, symbol digit coding) significantly showed to be decreased. The function of perception - response speed and steady movement were found to be more sensitive to ethanol than that of short - term memory, numerical ability and specification of color. No significant association were found between smoking, alcohol drinking, BMI(body mass index) and the effects of ethanol on neurobehavioral performance.
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