Va-Kei Kok, Hai-Sung Hsiao, Cheng-Chung Wang
CaseRepClinPractRev 2003; 4(1):57-61
Background: Afferent loop obstruction of the small intestine is a relatively uncommon complication of partial gastrectomy. Surgical revision of such a condition with jejunojejunostomy or Roux-en-Y conversion would appear to be the standard procedure for treatment for afferent loop obstruction.Case Report: We report on a case of a malignancy developing from a choledochal cyst in a patient who had previously undergone a Whipple‘s procedure. There were postoperative complications which included afferent loop syndrome. Repeated abdominal problems and post-surgical infection resulted in sepsis and malnourishment of our paitent. Percutaneous transhepatic duodenal drainage (PTDD) provided effective palliation for both afferent loop obstruction and biliary stasis.Conclusions: Our current case reveals a record of recurrent cancer as well as adhesion of the biliary tract and presence of a longer, redundant proximal jejunal loop resulting in afferent loop obstruction. Percutaneous catheter drainage should prove to be a useful alternative form of palliation for the treatment of afferent loop obstruction for selected patients who are considered by clinicians to be poor surgical candidates.
Keywords: Afferent Loop Syndrome, percutaneous transhepatic duodenal drainage