Case Report
Treatment of Afferent Loop Obstruction by Percutaneous Trans-Hepatic Biliary and Intestinal Drainage
Jun Tie1,2*, Zhao Yiming2, Liu Jiangtao2 and Liu Yingdi2
1Xijing Hospital of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
2Department of Gastroenterology, Hai Nan Branch of Chinese PLA General Hospital, Sanya, Hainan, 572000, China
- *Corresponding Author:
- Jun Tie
Xijing Hospital of Digestive Diseases
Xijing Hospital, Fourth Military Medical University
Xi'an, Shaanxi, 710032, China
Tel: 86 18629507963
E-mail: tiejun7776@163.com
Received date: February 06, 2015; Accepted date: February 25, 2015; Published date: March 05, 2015
Citation: Tie J, Zhao Yiming Z, Jiangtao L, Yingdi L (2015) Treatment of Afferent Loop Obstruction by Percutaneous Trans-Hepatic Biliary and Intestinal Drainage. J Palliat Care Med 5:213. doi: 10.4172/2165-7386.1000213
Copyright: © 2015 Tie J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
We presented a rare case of chronic afferent loop obstruction after radical resection of gastric carcinoma. A 44- year-old man was admitted because of “upper abdominal distension and abdominal pain for 3 months, skin and sclera jaundice for 2 weeks”. Abdominal CT revealed dilatation of the intrahepatic bile duct and common bile duct, a large, abdominal cystic lesion, as well as left adrenal gland metastasis. MRCP revealed that the cystic lesion was an expansion of loops. Thus, the diagnosis of afferent loop (A-loop) obstruction was made. Subsequently, the patient underwent percutaneous transhepatic cholangial drainage (PTCD). The patient’s abdominal pain was significantly reduced, and the jaundice subsided. We should consider the possibility of the occurrence of the left adrenal metastasis and abdominal lymph node metastasis led to a chronic obstruction of A-loop. The chronic obstruction gradually developed into a complete blockage, further causing biliary obstruction and resulting in the occurrence of severe jaundice and abdominal pain. Here we not only reported a case of chronic afferent loop obstruction following radical resection of gastric carcinoma, but also analyzed the characteristic features of CT imaging and treatment. This case report is a good reference to similar gastrointestinal malignancy.
