Abstract
Afferent loop syndrome caused by stenosis of jejunojejunal anastomosis of Roux-en-Y reconstruction
Highlights
Afferent loop syndrome (ALS) is an infrequent complication originally described with Billroth II gastrojejunostomy
Case presentation We present a case of a 32 years old woman presented with moderate to severe epigastric pain and non-bilious vomiting for the one-day duration
ALS is a mechanical complication that occurs in 1% of the afferent loops of Billroth II gastrojejunostomy
Summary
Afferent loop syndrome (ALS) is an infrequent complication originally described with Billroth II gastrojejunostomy. Ultrasonography revealed features of acute pancreatitis, a close by aperistaltic loop of the small bowel and a normal biliary tree. Based on these findings, the patient was diagnosed and treated as acute pancreatitis. The Sri Lanka Journal of Surgery 2019; 37(2): 30 - 31 where the facilities were available It revealed a dilated afferent loop and a concealed perforation. Emergency exploratory laparotomy was performed and detected a stenosed jejunojejunal anastomosis site (Figure 1) and grossly dilated afferent loop with a perforation at first part of the duodenum opening into the less sac. Stenosed Jejunojejunostomy was disconnected and new jejunojejunal anastomosis was created Despite the surgery, she continued to have a high output biliary drain through the surgical site drain. The patient expired on the tenth day after admission despite continued intensive care
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