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

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

Research output: Contribution to journalArticle

20 Citations (Scopus)

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

Fingerprint

Gastroenterostomy
Pancreatitis
Gastrectomy
Hyperamylasemia
Abdominal Pain
Extremities
Pancreatic Pseudocyst
Surgical Decompression
Gastrointestinal Diseases
Acute Pain
Laparotomy
Signs and Symptoms
Tomography

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{a1be693e5fd84ad5b455e1989c6c1824,
title = "Afferent loop obstruction presenting as acute pancreatitis and pseudocyst: Case reports and review of the literature",
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.",
author = "Conter, {R. L.} and Converse, {J. O.} and Thomas McGarrity and Koch, {K. L.}",
year = "1990",
month = "1",
day = "1",
language = "English (US)",
volume = "108",
pages = "22--27",
journal = "Surgery",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "1",

}

Afferent loop obstruction presenting as acute pancreatitis and pseudocyst : Case reports and review of the literature. / Conter, R. L.; Converse, J. O.; McGarrity, Thomas; Koch, K. L.

In: Surgery, Vol. 108, No. 1, 01.01.1990, p. 22-27.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Afferent loop obstruction presenting as acute pancreatitis and pseudocyst

T2 - Case reports and review of the literature

AU - Conter, R. L.

AU - Converse, J. O.

AU - McGarrity, Thomas

AU - Koch, K. L.

PY - 1990/1/1

Y1 - 1990/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0025296060&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025296060&partnerID=8YFLogxK

M3 - Article

C2 - 2360186

AN - SCOPUS:0025296060

VL - 108

SP - 22

EP - 27

JO - Surgery

JF - Surgery

SN - 0039-6060

IS - 1

ER -