A Patient of Acute Afferent Loop Obstruction Caused by Peritoneal Carcinomatosis Associated with Recurrence of Igastric Carcinoma was Successfully Treated by Endoscopic Drainage and Intestinal Stenting, with Improvement of the Quality of Life

Abstract

A 70-year-old man was admitted to our hospital with upper abdominal pain. He had previously undergone Billroth typeII total gastrectomy for advanced gastric cancer. Abdominal CT showed a dilated afferent loop. We diagnosed acute afferent loop obstruction caused by cancer recurrence or peritoneal dissemination. He was treated by endoscopic decompression of the afferent loop, followed by continuous drainage. After drainage, we successfully inserted a self expandable metallic stent (EMS). The patient was able to spend the final 6 months of his life at home with an adequately maintained quality of life due to this intervention. Our experience using the EMS in this patient suggests that endoscopic drainage, which is minimally invasive, should perhaps be considered when acute afferent loop obstruction occurs as a result of tumor recurrence.