title: Percutaneous Cholangioscopic Lithotripsy for Afferent Loop Syndrome Caused by Enterolith Development after Roux-en-Y Hepaticojejunostomy: A Case Report.
abstract: Afferent loop obstruction caused by enterolith formation is rare and cannot be easily treated with endoscopy because of the difficulty associated with the nonsurgical removal of enteroliths. A 74-year-old woman was admitted with fever and acute abdominal pain. Clinical features and imaging studies suggested afferent loop obstruction caused by an enterolith after Roux-en-Y hepaticojejunostomy. Percutaneous transhepatic biliary drainage was initially performed because of severe cholangitis with septic shock. The enterolith was located in the jejunal limb adjacent to the hepaticojejunostomy site. Cholangioscopic lithotripsy was performed through the percutaneous transhepatic route to the enterolith, and the fragments were moved into the efferent loop using scope push and saline flush methods. Here, we describe a case of afferent loop syndrome caused by an enterolith that developed after Roux-en-Y hepaticojejunostomy and was treated with percutaneous transhepatic cholangio-enteroscopic lithotripsy.
authors: Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors: Seong Hyun
authors: SH
authors: Kim
authors: Seok
authors: S
authors: Jeong
authors: Don Haeng
authors: DH
authors: Lee
authors: Sung Soo
authors: SS
authors: Yoo
authors: Keon-Young
authors: KY
authors: Lee
keywords: Afferent loop syndrome; Anastomosis, Roux-en-Y; Lithotripsy