J.Jpn. Surg. Soc.. 83(10): 1252-1256, 1982

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Original article

A SUCCESSFUL CASE OF AFFERENT LOOP OBSTRUCTION CAUSED BY A GALLSTONE

A 59-year-old female with gastric ulcer underwent a gastrectomy with antecolic gastrojejunostomy and fixation of the afferent loop to the lesser curvature 14 years ago. No Braun’s anastomosis was performed. When she visited our hospital, a tumor was palpable in the right hypochondrium. Five months later, she was attacked by a severe abdominal pain and vomited no bile. There were signs of peritonitis. Laparotomy revealed a stone obstructing the afferent jejunal loop 5cm distal to the Treitz ligament. There was a perforation in the third portion of the duodenum. The gallbladder and the common duct were enlarged. The perforation was sutured. The stone was removed by enterotomy. The jejunostomy, cholecystectomy, choledochal drainage and peritoneal drainage were performed. The gallstone measured 4.1×4.0×3.8cm and was a calcium bilirubinate stone.
According to Japanese literature, 121 cases of afferent loop obstruction have been reported, and the cause was attributed to internal hernia, adhensions, kinking, volvulus or strangulation.

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