title: [Acute pancreatitis and afferent loop syndrome. Case report].
abstract: BACKGROUND
  The afferent syndrome loop is a mechanic obstruction of the afferent limb before a Billroth II or Roux-Y reconstruction, secondary in most of case to distal or subtotal gastrectomy. Clinical case: Male 76 years old, with antecedent of cholecystectomy, gastric adenocarcinoma six years ago, with subtotal gastrectomy and Roux-Y reconstruction. Beginning a several abdominal pain, nausea and vomiting, abdominal distension, without peritoneal irritation sings. Amylase 1246 U/L, lipase 3381 U/L. Computed Tomography with thickness wall and dilatation of afferent loop, pancreas with diffuse enlargement diagnostic of acute pancreatitis secondary an afferent loop syndrome.
  
  
  CONCLUSIONS
  The afferent loop syndrome is presented in 0.3%-1% in all cases with Billroth II reconstruction, with a mortality of up to 57%, the obstruction lead accumulation of bile, pancreatic and intestinal secretions, increasing the pressure and resulting in afferent limb, bile conduct and Wirsung conduct dilatation, triggering an inflammatory response that culminates in pancreatic inflammation. The severity of the presentation is related to the degree and duration of the blockage.
authors.affiliation: Cirugía General, Hospital de Especialidades Dr. Bernardo Sepúlveda, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, México DF, Mexico. embarajas_84@hotmail.com.
authors.forename: Elpidio Manuel
authors.initials: EM
authors.lastname: Barajas-Fregoso
authors.affiliation: Servicio de Gastrocirugía, Hospital de Especialidades Dr. Bernardo Sepúlveda, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, México DF, Mexico.
authors.forename: Teodoro
authors.initials: T
authors.lastname: Romero-Hernández
authors.affiliation: Unidad de Investigación en Epidemiología Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades Dr. Bernardo Sepúlveda, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, México DF, Mexico.
authors.forename: Michel Dassaejv
authors.initials: MD
authors.lastname: Macías-Amezcua
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000230:Adenocarcinoma / Q000601:surgery; D000343:Afferent Loop Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D002763:Cholecystectomy; D003131:Combined Modality Therapy; D005215:Fasting; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D010195:Pancreatitis / Q000097:blood / Q000209:etiology* / Q000628:therapy; D011178:Postgastrectomy Syndromes / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D013274:Stomach Neoplasms / Q000601:surgery; D063189:Symptom Assessment; D014057:Tomography, X-Ray Computed; D014839:Vomiting / Q000209:etiology; D014882:Water-Electrolyte Balance
chemical_list: D000700:Analgesics
keywords: Acute pancreatitis; afferent loop syndrome; gastrectomy; gastrectomía; pancreatitis aguda; síndrome de asa aferente