Afferent loop syndrome is an uncommon complication which occurs in patients with Billroth II partial gastrectomy. Clinically, the diagnosis of afferent loop syndrome may be difficult to establish and thus, depends on the finding of computed tomography, abdominal ultrasound, barium studies and hepatobiliary scan. When the diagnosis is made, most of the cases are treated by surgical operation. We present a case of 67-year-old male patient with afferent loop syndrome associated with acute pancreatitis which was treated by endoscopic drainage procedure using a nasogastric tube.
Acute Disease ; Afferent Loop Syndrome/*diagnosis/etiology/*surgery ; Aged ; Drainage ; Endoscopy, Gastrointestinal ; Gastroenterostomy ; Hernia ; Humans ; *Intubation, Gastrointestinal/instrumentation ; Male ; Pancreatitis/complications/diagnosis/surgery ; Tomography, X-Ray Computed

Acute pancreatitis and afferent loop syndrome (ALS) have similar symptoms and physical findings. Accurate early diagnosis is essential, as the management of acute pancreatitis is predominantly conservative whereas ALS usually requires surgery. We experienced one case of pancreatitis due to ALS with internal hernia. Laboratory findings of patient showed elevated serum amylase, lipase and WBC count. One day after admission, diagnosis was modified as acute pancreatitis caused by ALS on computed tomography. Patient was managed with surgical treatment and operation finding revealed ALS due to internal hernia. He was recovered well after surgical treatment and discharged without significant sequelae.
Acute Disease ; Afferent Loop Syndrome/complications/*diagnosis/surgery ; Endoscopy, Gastrointestinal ; Gallstones ; Hernia, Abdominal/*complications ; Humans ; Male ; Middle Aged ; Pancreatitis/*diagnosis/etiology ; Radiography, Abdominal ; Tomography, X-Ray Computed

Afferent loop syndrome is a rare complication which can occur in patients with Billroth II gastrectomy. Bile and pancreatic juice is congested at afferent loop in the syndrome. This syndrome can progress rapidly to necrosis, perforation, or severe sepsis, and therefore early diagnosis and swift surgical intervention is important. But, cases of endoscopic or percutaneous transhepatic drainage have been reported when surgical management was inappropriate to proceed. We report a case of afferent loop syndrome accompanying acute cholangitis developed after percutaneous transhepatic cholangioscopic lithotripsy for the retrieval of common bile duct stone in a patient who underwent Billroth II gastrectomy due to early gastric cancer. There was no other organic cause. We treated afferent loop syndrome successfully by performing balloon dilation of afferent loop outlet.
Acute Disease ; Afferent Loop Syndrome/*etiology ; Aged, 80 and over ; Balloon Dilation ; Cholangiography ; Cholangitis/*etiology ; Choledocholithiasis/*diagnosis/radiography/therapy ; Common Bile Duct ; Gallstones/*diagnosis/therapy ; Gastroenterostomy ; Humans ; Lithotripsy/*adverse effects ; Male ; Stomach Neoplasms/surgery ; Tomography, X-Ray Computed