Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016:2016:4930354.
doi: 10.1155/2016/4930354. Epub 2016 Jun 26.

Afferent Loop Syndrome after Roux-en-Y Total Gastrectomy Caused by Volvulus of the Roux-Limb

Hideki Katagiri  1 , Kana Tahara  1 , Kentaro Yoshikawa  1 , Alan Kawarai Lefor  2 , Tadao Kubota  1 , Ken Mizokami  1
Affiliations

Afferent Loop Syndrome after Roux-en-Y Total Gastrectomy Caused by Volvulus of the Roux-Limb

Hideki Katagiri et al. Case Rep Surg. 2016.

Abstract

Afferent loop syndrome is a rare complication of gastric surgery. An obstruction of the afferent limb can present in various ways. A 73-year-old man presented with one day of persistent abdominal pain, gradually radiating to the back. He had a history of total gastrectomy with a Roux-en-Y reconstruction. Abdominal computed tomography scan revealed dilation of the duodenum and small intestine in the left upper quadrant. Exploratory laparotomy showed volvulus of the biliopancreatic limb that caused afferent loop syndrome. In this patient, the 50 cm long limb was the cause of volvulus. It is important to fashion a Roux-limb of appropriate length to prevent this complication.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Abdominal computed tomography scan revealed dilation of the duodenum and small intestine in the left upper quadrant.
Figure 2
Figure 2
Computed tomography scan images with axial and coronal views showing slight dilation of the main pancreatic duct (arrow heads) and the intrahepatic bile duct (arrow).
Figure 3
Figure 3
Schematic diagram of intraoperative findings. The patient previously underwent total gastrectomy and cholecystectomy. The afferent (biliopancreatic) limb was twisted 360 degrees.
See this image and copyright information in PMC

References

    1. Aoki M., Saka M., Morita S., Fukagawa T., Katai H. Afferent loop obstruction after distal gastrectomy with Roux-en-Y reconstruction. World Journal of Surgery. 2010;34(10):2389–2392. doi: 10.1007/s00268-010-0602-5. - DOI - PubMed
    1. Kim H.-C., Han J. K., Kim K. W., et al. Afferent loop obstruction after gastric cancer surgery: helical CT findings. Abdominal Imaging. 2003;28(5):624–630. doi: 10.1007/s00261-002-0070-y. - DOI - PubMed
    1. Fleser P. S., Villalba M. Afferent limb volvulus and perforation of the bypassed stomach as a complication of Roux-en-Y gastric bypass. Obesity Surgery. 2003;13(3):453–456. doi: 10.1381/096089203765887831. - DOI - PubMed
    1. Han K., Song H.-Y., Kim J. H., et al. Afferent loop syndrome: treatment by means of the placement of dual stents. American Journal of Roentgenology. 2012;199(6):W761–W766. doi: 10.2214/ajr.12.8575. - DOI - PubMed
    1. Cho Y. S., Lee T. H., Hwang S. O., et al. Electrohydraulic lithotripsy of an impacted enterolith causing acute afferent loop syndrome. Clinical Endoscopy. 2014;47(4):367–370. doi: 10.5946/ce.2014.47.4.367. - DOI - PMC - PubMed

LinkOut - more resources