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Case Reports
. 2023 May 6;10(5):e01043.
doi: 10.14309/crj.0000000000001043. eCollection 2023 May.

Afferent Loop Syndrome as Second Presentation of Gastric Outlet Obstruction in Patient With Billroth II Anatomy

Brenton G Davis  1 , Alexis M Bayudan  2 , Abdul M Kouanda  2
Affiliations
Case Reports

Afferent Loop Syndrome as Second Presentation of Gastric Outlet Obstruction in Patient With Billroth II Anatomy

Brenton G Davis et al. ACG Case Rep J. .

Abstract

Afferent loop syndrome can result from both benign and malignant strictures of the biliary limbs of patients with surgically altered anatomy. Afflicted patients accumulate intestinal and pancreaticobiliary secretions, which leads to bowel distention and pain. We describe the endoscopic management of a 52-year-old woman with a history of Billroth II gastrojejunostomy due to gastric cancer who developed malignant gastric outlet obstruction and subsequently malignant afferent loop syndrome, using lumen-apposing metal stents.

Keywords: Billroth II; afferent loop syndrome; gastric outlet obstruction.

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Figures

Figure 1.
Figure 1.
Abdominal/pelvic computed tomography image of transition point adjacent to gastrojejunostomy sutures.
Figure 2.
Figure 2.
Abdominal/pelvic computed tomography image of patent gastrojejunostomy lumen-apposing metal stent without distal small bowel dilation.
Figure 3.
Figure 3.
Wire access of the dilated afferent loop.
Figure 4.
Figure 4.
Endoscopic ultrasound image of afferent limb and balloon.
Figure 5.
Figure 5.
Balloon dilation of jejunojejunostomy lumen-apposing metal stent.
Figure 6.
Figure 6.
Plain film of deployed gastrojejunostomy and jejunojejunostomy lumen-apposing metal stent.
See this image and copyright information in PMC

References

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