A healthy 45-year-old woman with a previous Roux-en-Y gastric bypass p
resented with the signs, symptoms and blood analysis results consisten
t with acute pancreatitis. She was initially treated nonoperatively an
d subsequently went into circulatory shock. Computerized tomographic s
can and exploratory laparotomy revealed a volvulus of the afferent jej
unal limb with secondary obstruction, necrosis, and perforation of the
bypassed stomach. (C) 1998 Lippincott-Raven Publishers.