Acute Abdomen Caused by Complicated Afferent Loop Syndrome after Gastrectomy

Jung, In Seop; Kim, Jae Han; Kim, Eun Joo; Chung, Il Kwun; Lee, Moon Soo; Kim, Hong Soo; Park, Sang Heum; Lee, Moon Ho; Kim, Sun Joo

Abstract

Afferent loop syndrome results from obstruction of the afferent limbs of a loop after gastrojejunostomy. It is an uncommon problem encountered after gastrectomy and Billroth II reconstruction. It may begin acutely within a few days after surgery, or it may manifest as a chronic syndrome months to years after surgery. Acute pancreatitis and duodenal stump perforation complicated by the chronic afferent loop obstruction after gastrectomy and Billroth II reconstruction are rarely recognized, and often occur many years after the initial operation. These serious complications have diagnostic difficulty, grave prognosis, and high mortality. We experienced two patients who had complications of afferent loop syndrome, but showed contradictory clinical progress. One patient had acute pancreatitis and another patient had duodenal stump perforation. We report these cases with a review of relevant literatures.