Abstract
Afferent loop obstruction is a complication following gastrectomy, and we experienced one such case, which was successfully treated with emergency surgery. A 52-year-old man suffering from duodenal stenosis due to a duodenal ulcer underwent a distal gastrectomy reconstructed with the antecolic Billroth-II method with a Braun anastomosis. The patient complained of epigastric pain on the 23rd day after surgery, and on the 25th day he had signs of peritonitis. An emergency operation was performed under the preoperative diagnosis of afferent loop obstruction. Upon laparotomy, the afferent loop was remarkably dilated by a retained pool of intestinal juice. The afferent loop was twisted by an adhesive lesion between the Treitz ligament and the Braun anastomosis. The duodenal stump was perforated. The twisted afferent loop was straightened again and the duodenal stump perforation was directly sutured. A drainage tube was inserted from the efferent loop to the duodenal stump via the Braun anastomosis. The patient had an uneventful postoperative course and was discharged from our hospital on the 38th day after the 2nd operation.
