Afferent loop obstruction after gastrectomy simulating acute pancreatitis

Abstract

After gastrectomy and Billroth II anastomosis, if the afferent loop is too long, it may kink and herniate, resulting in obstruction. If it is too short, it may produce acute angulation with obstruction. This condition often simulates acute pancreatitis when the amylase level in urine and serum is increased. Three cases of afferent loop obstruction are reported. The patient who did not undergo laparotomy died; the other two were operated on and survived. The diagnosis, etiology and treatment of these complications are discussed, and similar cases reported in the literature are cited.