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