Laparoscopy in afferent loop obstruction presenting as acute pancreatitis.
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.
Vettoretto
Nereo
N
Division of General and Vascular Surgery, Department of Surgery, Mellino Mellini Hospital, Chiari (BS), Italy. nereovet@hotmail.com
Pettinato
Giovanna
G
Romessis
Matheos
M
Bravo
Andrea Ferrari
AF
Barozzi
Geraldine
G
Giovanetti
Maurizio
M
D000208:Acute Disease; D000328:Adult; D000343:Afferent Loop Syndrome / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010195:Pancreatitis / Q000209:etiology*