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Retroanastomotic hernia after gastrojejunostomy: US and CT findings with an emphasis on the whirl sign

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Author(s)
J. H. KwonH. Y. Jang
Keimyung Author(s)
Kwon, Jung HyeokChang, Hyuk Won
Department
Dept. of Radiology (영상의학)
Journal Title
Abdominal Imaging
Issued Date
2005
Volume
30
Issue
6
Abstract
Background:We reviewed ultrasound (US) and computed
tomographic (CT) findings of retroanastomotic hernia
and established whether such findings are characteristic
of retroanastomotic hernia in patients who have undergone
gastrojejunostomy.
Methods: During a recent 10-year period, we encountered
13 consecutive cases of retroanastomotic hernia. Of the
patients involved, 11 underwent US, 10 underwent CT,
and three underwent small bowel followthrough imaging.
The US and CT scans were retrospectively reviewed to
determine abnormal findings. Surgical proof was available
in all cases.
Results: The efferent loop was herniated through the defect
created behind the anastomosis in 10 cases, the efferent
and afferent loops in two cases, and the afferent loop in
one case. Retroanastomotic hernia was prospectively
suggested in 12 of these 13 cases. Among the 10 cases of
efferent loop herniation, US and CT signs of retroanastomotic
hernia included whirling of mesenteric vessels,
jejunal loops, and mesentery in the periumbilical abdomen
(10 of 10); mural thickening of herniated bowel loops (six
of 10); dilatation of herniated bowel loops (four of 10);
decreased peristalsis of herniated bowel loops onUS (three
of nine); and decreased contrast enhancement of herniated
bowel loops on CT (one of seven). In one case, US and CT
signs of retroanastomotic hernia of the afferent loop included
its dilatation and whirling of a short length of
afferent loop behind the anastomosis. In two cases, US
and CT signs of retroanastomotic hernia of the afferent
and efferent loops included findings of afferent and
efferent loop herniations. Three of 13 cases had reversible
bowel ischemia, and one had bowel necrosis.
Conclusion: Retroanastomotic hernia is an important
condition, and the US and CT findings we have described
might suggest its diagnosis.
Key words: Hernia—Intestines—Obstruction—Computed
tomography—Ultrasound—Gastrojejunostomy
Keimyung Author(s)(Kor)
권중혁
장혁원
Publisher
School of Medicine
Citation
J. H. Kwon and H. Y. Jang. (2005). Retroanastomotic hernia after gastrojejunostomy: US and CT findings with an emphasis on the whirl sign. Abdominal Imaging, 30(6), 656–664. doi: 10.1007/s00261-005-0310-z
Type
Article
ISSN
0942-8925
Source
https://link.springer.com/article/10.1007%2Fs00261-005-0310-z
DOI
10.1007/s00261-005-0310-z
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34843
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
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