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Review
. 2006 Apr-Jun;10(2):270-4.

Laparoscopy in afferent loop obstruction presenting as acute pancreatitis

Nereo Vettoretto  1 , Giovanna Pettinato, Matheos Romessis, Andrea Ferrari Bravo, Geraldine Barozzi, Maurizio Giovanetti
Affiliations
Review

Laparoscopy in afferent loop obstruction presenting as acute pancreatitis

Nereo Vettoretto et al. JSLS. 2006 Apr-Jun.

Abstract

Background: We describe an afferent loop obstruction caused by an adhesion band in a case of distal gastrectomy with Roux-en-Y end-to-side jejunal anastomosis for cancer.

Methods: An initial clinical presentation of acute pancreatitis was ruled out by a computed tomography scan, which revealed intestinal obstruction; it was then confirmed on laparoscopy. Definitive treatment was laparoscopic adhesiolysis. A complete review of the literature concerning afferent loop obstructions is presented.

Results: The treatment was successful, with minimal postoperative pain, and the 5-day hospital stay was uncomplicated. The patient remains asymptomatic at 1-year follow-up.

Conclusions: The authors advocate minimally invasive surgery as a complete diagnostic and therapeutic alternative to emergency laparotomy in cases where afferent loop syndrome is suspected, and acknowledge that prompt surgery has a higher rate of success and reduces operative morbidity and mortality.

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Figures

Figure 1.
Figure 1.
Computed tomographic scan: dilated duodenum stump (clearly identified by metallic suture line).
Figure 2.
Figure 2.
Intraoperative findings: lysis of the adhesive band.
See this image and copyright information in PMC

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