Abstract
An elderly patient presented to our institution with abdominal pain, nausea and vomiting. She had an extensive surgical background including gastrectomy with Roux-en-y reconstruction undertaken 15 years earlier. A CT abdomen demonstrated a small bowel obstruction proximal to the jejunojejunostomy with features suggestive of afferent loop syndrome (ALS), a rare but known complication following Roux-en-y reconstruction. Initial surgery identified a band adhesion and an associated ischemic small bowel segment, which was resected with primary anastomosis. A further operation was required at post-operative day five due to clinical deterioration. A retroperitoneal collection was identified secondary to perforation of the afferent loop.
Highlights
This is a rare case and potentially the first case report in the literature of intestinal perforation secondary to afferent loop syndrome
Afferent loop syndrome is a life threatening condition with mortality reported at 30-60% in the literature
Retrospective analysis of the CT examination led to the conclusion that the perforation occurred prior to admission and in a diverticulum in the afferent limb (Figure 1)
Summary
This is a rare case and potentially the first case report in the literature of intestinal perforation secondary to afferent loop syndrome. Afferent loop syndrome is a life threatening condition with mortality reported at 30-60% in the literature. In a patient presenting with obstructive symptoms with a background of gastrectomy with Roux-en-y reconstruction it is important to consider ALS as a potential diagnosis and prompt surgical management is required
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
