Blind loop syndrome (or "blind pouch syndrome") is an event that may occur after an end-to-end or end-to-side bowel anastomosis. Dilatation and stasis of the bypassed bowel may lead to bacterial overgrowth, breakdown of bile salts, and result in nutritional problems. It may even eventually lead to mucosal ulceration.
A "blind loop" is the term used when the bypassed loop of bowel is surgically intentional. A "blind pouch" is a shorter stub of bypassed bowel at the anastomosis.
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Clinical presentation
- nausea
- diarrhea
- steatorrhea
- possible nutritional deficiencies, such as vitamin B12 deficiency
Radiographic features
Abdominal radiograph
- appears as a non-specific spherical or tubular collection of intra-abdominal gas
- the blind loop may not be visible if it contains food or debris
Fluoroscopy
- a small bowel follow-through may delineate the pouch
CT
- focally distended segment of bowel at the anastomosis
- surgical clips are usually adjacent to the pouch
- pouch may be filled with fluid or fecal material
A blind loop or blind pouch may be misinterpreted as an abscess or small bowel obstruction
Treatment and prognosis
Complications from the blind loop include mucosal ulceration, enterolith formation, or perforation 3.