[Obstructive jaundice and acute pancreatitis due to an obstruction of the afferent loop after billroth-II-resection].
An obstruction of the afferent loop after Billroth-II-resection is an extremely rare late complication of this procedure. We report on a 76-year-old female patient with a history of Billroth-II-resection 11 years ago who was admitted due to acute pancreatitis and obstructive jaundice. Abdominal sonography lead to the suspicion of a dilated afferent loop, which could be proven by means of magnetic resonance imaging. A tumorous lesion as cause of the obstructive jaundice was not detectable. Intraoperatively a volvulus of the small intestine and strangling adhesions near the Braun's anastomosis were seen, causing the obstruction of the afferent loop. Following reposition of the small intestine and adhesiolysis the patient gained a quick relief of symptoms and the jaundice disappeared completely.
Wimmer
L
L
Interne Abteilung/Gastroenterologie, Osterreich, Germany..
Kirchgatterer
A
A
Aschl
G
G
Kranewitter
W
W
Stadler
B
B
Strobl
M
M
Kalchmair
H
H
Funk
S
S
Dinkhauser
L
L
Knoflach
P
P
D000208:Acute Disease; D000343:Afferent Loop Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000368:Aged; D000714:Anastomosis, Surgical; D002758:Cholangiography; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation