Afferent loop obstruction: Clinical analysis and literature review

Acute obstruction of the afferent loop is an unusual and disastrous complication after gastrectomy and Billroth II reconstruction. It may happen within days after surgery, or wait till months or years later. Complete acute obstruction of the afferent loop causes sudden upper abdominal pain, nonbilious vomiting, and rapid clinical deterioration. It needs an emergency operation to relieve the obstruction, or a high morbidity or mortality rate will result. Hyperamylasemia is common in afferent loop obstruction, and it often misleads physicians to mistakenly diagnose acute pancreatitis, and delay the operation. We collected 6 cases retrospectively over a period of 7 years and found that all cases had a delayed diagnosis and there was a mortality rate of 33.3%.