title: Afferent Loop Syndrome after Roux-en-Y Total Gastrectomy Caused by Volvulus of the Roux-Limb.
abstract: Afferent loop syndrome is a rare complication of gastric surgery. An obstruction of the afferent limb can present in various ways. A 73-year-old man presented with one day of persistent abdominal pain, gradually radiating to the back. He had a history of total gastrectomy with a Roux-en-Y reconstruction. Abdominal computed tomography scan revealed dilation of the duodenum and small intestine in the left upper quadrant. Exploratory laparotomy showed volvulus of the biliopancreatic limb that caused afferent loop syndrome. In this patient, the 50 cm long limb was the cause of volvulus. It is important to fashion a Roux-limb of appropriate length to prevent this complication.
authors.affiliation: Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
authors.forename: Hideki
authors.identifier: 0000-0002-2786-8569
authors.initials: H
authors.lastname: Katagiri
authors.affiliation: Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
authors.forename: Kana
authors.initials: K
authors.lastname: Tahara
authors.affiliation: Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshikawa
authors.affiliation: Department of Surgery, Jichi Medical University, 1-3311 Yakushiji, Shimotsuke, Tochigi Prefecture 329-0498, Japan.
authors.forename: Alan Kawarai
authors.initials: AK
authors.lastname: Lefor
authors.affiliation: Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
authors.forename: Tadao
authors.initials: T
authors.lastname: Kubota
authors.affiliation: Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Mizokami