Afferent loop obstruction presenting as acute pancreatitis and pseudocyst: Case reports and review of the literature

R. L. Conter, J. O. Converse, T. J. McGarrity, K. L. Koch

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Afferent loop obstruction after gastrectomy and Billroth II reconstruction is an uncommon problem. Complete acute obstruction requires emergent laparotomy. However, chronic obstruction may begin insidiously and its symptoms may reflect other gastrointestinal diseases. Two patients are described who developed acute abdominal pain, marked hyperamylasemia, and palpable abdominal masses 5 and 15 years after Billroth II gastrectomy. The masses were initially interpreted as pancreatic pseudocysts. Both patients were found to have chronically obstructed afferent limbs, and in one the obstruction was associated with hundreds of stasis stones within the afferent limb. Surgical decompression was accomplished in each patient. Patients who have undergone Billroth II reconstruction have signs, symptoms, and laboratory findings consistent with acute pancreatitis. A history of previous gastrectomy, recurrent or severe abdominal pain, hyperamylasemia with characteristic tomography, and endoscopic findings will establish the diagnosis and necessitate surgical evaluation and intervention.

Original languageEnglish (US)
Pages (from-to)22-27
Number of pages6
JournalSurgery
Volume108
Issue number1
StatePublished - Jan 1 1990

All Science Journal Classification (ASJC) codes

  • Surgery

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