1/30. Enterolith: an unusual cause of afferent loop obstruction.Most cases of enterolith have been reported in association with the diverticula of small bowel. We report here a case of a patient in whom a huge enterolith developed in the afferent loop of Billroth II anastomosis with ensuing obturation obstruction. The enterolith was clearly shown on the preoperative abdominal computed tomograph and was removed through a duodenotomy. The postulated mechanism of the enterolith formation is impaired duodenal evacuatory motor activity due to previous gastrectomy.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
2/30. Percutaneous bowel drainage for jaundice due to afferent loop obstruction following pancreatoduodenectomy: report of a case.A case of jaundice due to an obstruction of the afferent loop following a pancreatoduodenectomy is presented. The dilated loop of the jejunum was drained percutaneously with a 12-F gastrostomy tube. Localized peritonitis around the puncture site was managed conservatively and the obstructive jaundice improved. The treatment strategy for this type of jaundice is discussed.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
3/30. Jejunal limb obstruction caused by a cholesterol stone 15 years after a total gastrectomy and 20 years after a cholecystectomy: report of a case.We present herein the rare case of a 74-year-old woman found to have jejunal limb obstruction caused by a cholesterol stone 15 years after a total gastrectomy with Roux-en-Y anastomosis, and 20 years after a cholecystectomy. The patient complained of repeated episodes of upper abdominal distress on three separate occasions over a period of 20 months, and jejunal limb obstruction was diagnosed by abdominal computed tomography scanning and (99m)Tc scintigraphy. Surgery revealed a stone incarcerated in the jejunal limb, where the anastomosis had become slightly stenotic. The removed stone was 3.5 cm in diameter and was subsequently demonstrated to be a cholesterol stone by chemical analysis. This report is thought to be the first to describe jejunal limb obstruction caused by a gallstone incarcerated in the jejunal limb after a total gastrectomy in a patient with a history of cholecystectomy.- - - - - - - - - - ranking = 1.4keywords = obstruction (Clic here for more details about this article) |
4/30. Sonographic detection of visceral adhesion in percutaneous drainage of afferent-loop small-intestine obstruction.To facilitate the percutaneous drainage of an afferent-loop small-intestine obstruction, we used sonography to detect visceral adhesions and select a safe puncture route. The portion of the small intestine that was fixed to the anterior abdominal wall was sonographically identified by using a high-frequency transducer to locate the area of restricted visceral sliding. The needle was then inserted into the intestine. In 3 cases, we have found that this technique improves the confidence of the physicians who perform the percutaneous drainage and may help to minimize the risks associated with the percutaneous drainage.- - - - - - - - - - ranking = 1keywords = obstruction (Clic here for more details about this article) |
5/30. Transhepatic insertion of a metallic stent for the relief of malignant afferent loop obstruction.A 65-year-old man with a polya gastrectomy presented with biliary obstruction. Percutaneous cholangiography indicated strictures of the distal common bile duct and afferent duodenal loop due to an inoperable carcinoma of the head of the pancreas. The patient was unfit for bypass surgery, and a previous gastrectomy precluded endoscopic intervention. Successful palliation of the biliary obstruction was achieved by placing metallic stents across the duodenal and biliary strictures via the transhepatic route. The use of stents for gastrointestinal stricture is reviewed.- - - - - - - - - - ranking = 1.210167349463keywords = obstruction, bile duct, bile, duct (Clic here for more details about this article) |
6/30. afferent loop syndrome: the role of Tc-99m mebrofenin hepatobiliary scintigraphy.afferent loop syndrome is caused by intermittent mechanical obstruction of the afferent loop of a gastrojejunostomy and may present early as an acute type or late as a chronic type. The authors describe two patients who were examined for a history of bilious vomiting after gastrojejunostomy, and who were thought to have afferent loop syndrome (chronic type) based on clinical findings. Results of routine investigations, such as upper gastrointestinal endoscopy, and ultrasonography were inconclusive. Findings from the barium meal follow-through studies were normal in the first patient and revealed a dilated duodenum in the second patient. Tc-99m bromotriethyl-iminodiacetic acid has been used to identify afferent loop obstruction as represented in these studies.- - - - - - - - - - ranking = 0.4keywords = obstruction (Clic here for more details about this article) |
7/30. Afferent loop obstruction with pancreatitis after distal partial gastrectomy with B-II reconstruction added Braun anastomosis for cancer of the stomach.Afferent loop obstruction after distal gastrectomy is rare. We present a case of a 59-year-old women who underwent distal partial gastrectomy with Billroth-II reconstruction added Braun anastomosis for cancer of the stomach. On the 10th postoperative day, she had high-grade fever and complained of abdominal pain. We diagnosed the afferent loop obstruction by computed tomography scan. Re-operation was performed to decompress the afferent loop. New Braun anastomosis was created, but because the decompression of the biliary tract was insufficient, percutaneous transhepatic biliary drainage was performed on the 52nd post-operative day. Her clinical course subsequently improved and she was discharged on the 104th postoperative day. This paper describes the details of this unusual condition, and we discuss a review of the literature.- - - - - - - - - - ranking = 1.2keywords = obstruction (Clic here for more details about this article) |
8/30. Afferent limb volvulus and perforation of the bypassed stomach as a complication of Roux-en-Y gastric bypass.A 35-year-old female who had previously undergone an open gastric bypass, underwent elective caesarian section and ventral hernia repair, complicated by a double closed-loop obstruction with resulting gastric perforation. back pain and anemetic nausea predominated, as proximal bowel and pancreatobiliary obstruction followed an afferent limb volvulus. pancreatitis, cholangitis, and gastric perforation ensued, leading to intraabdominal sepsis. This rare situation must be recognized as a potentially serious complication of gastric bypass surgery, and requires prompt recognition and aggressive surgical correction.- - - - - - - - - - ranking = 0.4keywords = obstruction (Clic here for more details about this article) |
9/30. carcinoma of gastric stump causing afferent loop obstruction and acute pancreatitis.We report a case of a 79-year-old man who had undergone partial gastrectomy with Billroth-II (B-II) anastomosis 42 years ago for benign peptic ulcer. He presented with abdominal pain, distention and acute pancreatitis. Esophagogastroduodenoscopy showed a malignant mass obstructing the afferent stoma; surgical resection was performed. Pathogenesis of acute pancreatitis in this case and the problem of gastric stump carcinoma are discussed.- - - - - - - - - - ranking = 0.8keywords = obstruction (Clic here for more details about this article) |
10/30. Acute pancreatitis caused by afferent loop herniation after Billroth II gastrectomy: report of a case and review of the literature.We present herein the rare case of a 44-year-old man found to have acute pancreatitis due to afferent limb obstruction caused by internal herniation, twelve years after Billroth II gastrectomy. The patient complained of nausea, vomiting, and epigastric pain in acute onset. physical examination, laboratory studies and computed tomography imaging revealed acute pancreatitis and peritonitis. The patient had been operated on urgently and afferent limb herniation was observed between the afferent loop's meso and duodenum. The herniated segment was incarcerated and the proximal segment of the afferent limb and duodenum were markedly dilated. Microperforations were also observed in the dilated proximal afferent limb. The herniated segment of the bowel was released and longitudinal plication and serosal patching procedure were performed on the afferent limb. The patient recovered after fifteen days and remained free of acute pancreatitis for two years.- - - - - - - - - - ranking = 0.2keywords = obstruction (Clic here for more details about this article) |
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