AFFERENT LOOP SYNDROME COMPLICATED BY A DUODENAL PHYTOBEZOAR AFTER BILLROTH-II SUBTOTAL GASTRECTOMY

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.