Radiological diagnosis and treatment of afferent loop obstruction

Four cases of afferent loop obtruction were reported. Billroth II reconstruction was performed in two patients and Roux-Y reconstruction was performed in the other two patients after gastrectomy. Three of four patients complained of jaundice. CT and ultrasonography showed a dumbell-shaped cystic mass anterior to the abdominal aorta on the transverse image, and a cystic mass between the superior mesenteric vessels and the abdominal aorta on saggital view. These patients were not surgical candidates because of their poor condition. We performed the drainage of the afferent loop via a percutaneus transhepatic biliary catheter as a palliative treatment. In one case the serum bilirubin and amylase level decreased to normal range and the patient survived for 80 days. The other two patients died on the 12th and 28th day after the procedure. One patient is currently alive 20 days after the drainage procedure with improvement of clinical symptoms, serum bilirubin and amylase levels.