2025 Volume 67 Issue 4 Pages 289-294
An 80-year-old man presented with epigastric pain and vomiting 4 years after undergoing distal gastrectomy with Roux-en-Y reconstruction for a gastric ulcer perforation. Enhanced abdominal CT and blood tests led to a diagnosis of afferent loop syndrome and acute pancreatitis. Endoscopic examination revealed afferent loop obstruction caused by an enterolith owing to anastomotic stenosis. We performed endoscopic balloon dilation of the anastomotic stricture and successfully removed the enterolith. Stone component analysis confirmed it was a true enterolith. The patient was discharged on the 13th postoperative day without complications or abdominal symptoms. This case is unique in two respects: afferent loop syndrome caused by a true enterolith and its successful management with endoscopic procedure. This experience may be valuable for treating similar cases of afferent loop syndrome.
