Ms. Hui et al., AFFERENT LOOP SYNDROME COMPLICATED BY A DUODENAL PHYTOBEZOAR AFTER BILLROTH-II SUBTOTAL GASTRECTOMY, The American journal of gastroenterology, 92(9), 1997, pp. 1550-1552
We illustrate a rare late onset (10 yr) complication of gastric surger
y with a combination of afferent loop syndrome and a large duodenal be
zoar, The patient underwent a subtotal gastrectomy with Billroth II ga
strojejunal anastomosis for benign peptic ulcer 10 yr ago, It was not
until several days before this presentation that he suffered from epig
astralgia and abdominal distension, Leukocytosis and abnormal blood bi
ochemistry were found including amylase, lipase, alkaline phosphatase,
total bilirubin, GOT, and GPT in which amylase was markedly elevated
to 1188 U/L, Abdominal ultrasound scan and especially CT scan confirme
d the diagnosis of a large bezoar in the dilated duodenal afferent loo
p, To our knowledge, the rare entity in our case is the first reported
in the literature.