Jejunal Loop Obstruction by a Gallstone from Hepaticojejunostomy-Induced Acute Cholangitis: Report of a Case

Shimamura, Kazuhiko; Otani, Tetsuya; Yamazaki, Toshiyuki; Kuwabara, Shirou; Katayanagi, Norio; Yamamoto, Mutsuo; Saito, Hideki

doi:10.1007/s00595-006-3228-3

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…Functional bile stasis can occur in the afferent,18 efferent19 or common jejunal limbs 20. Mechanical causes of bile stasis include kinked bowel21 or extensive adhesions 22…”

Section: Discussionmentioning

confidence: 99%

Gallstone ileus 30 years after cholecystectomy and hepaticojejunostomy

Todd,

Wong,

Covin

et al. 2023

BMJ Case Rep

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Gallstone ileus occurs when the small or large intestine is obstructed by a gallstone and is a rare occurrence in a post-cholecystectomy patient. Non-specific clinical symptoms and inconsistent imaging results often lead to a delay in diagnosis. Complex anatomy, such as a Roux-en-Y biliary-enteric anastomosis, can increase the risk of stone formation and further confound a potential case of gallstone ileus. Here, we present a rare case of gallstone ileus at the anastomosis site of a Roux-en-Y hepaticojejunostomy done 30 years prior for a common bile duct injury during a cholecystectomy. The possibility of negative CT findings, pattern of presentation on imaging as intussusception, and potential pathomechanism of gallstone formation in post-cholecystectomy patients are discussed. Through this case and review of similar cases, we emphasise the need for further study of post-cholecystectomy gallstone ileus and the importance of clinical suspicion during diagnosis.

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“…Functional bile stasis can occur in the afferent,18 efferent19 or common jejunal limbs 20. Mechanical causes of bile stasis include kinked bowel21 or extensive adhesions 22…”

Section: Discussionmentioning

confidence: 99%

Gallstone ileus 30 years after cholecystectomy and hepaticojejunostomy

Todd,

Wong,

Covin

et al. 2023

BMJ Case Rep

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“…4 Afferent loop syndrome is generally caused by mechanical occlusion due to the recurrence or metastasis of cancer, 4–6 adhesion, 7–8 torsion, 9 internal hernia, 10 enterolithiasis, 11–12 etc., and thereafter, leads to a syndrome associated with acute abdominal symptom or acute cholangitis. On the other hand, nonobstructive afferent loop syndrome may also be caused by biliary stasis due to jejunal motility failure or the length of the blind end or jejunum, and thereafter, leads to acute cholangitis, liver abscess, and the formation of enterolithiasis and intrahepatic stones.…”

mentioning

confidence: 99%

Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case

Sanada

Yamada

Taguchi

et al. 2014

International Surgery

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We report a 71-year-old man who had undergone pylorus-preserving pancreatoduodenectomy (PPPD) using PPPD-IV reconstruction for cholangiocarcinoma. For 6 years thereafter, he had suffered recurrent cholangitis, and also a right liver abscess (S5/8), which required percutaneous drainage at 9 years after PPPD. At 16 years after PPPD, he had been admitted to the other hospital because of acute purulent cholangitis. Although medical treatment resolved the cholangitis, the patient was referred to our hospital because of dilatation of the intrahepatic biliary duct (B2). Peroral double-balloon enteroscopy revealed that the diameter of the hepaticojejunostomy anastomosis was 12 mm, and cholangiography detected intrahepatic stones. Lithotripsy was performed using a basket catheter. At 1 year after lithotripsy procedure, the patient is doing well. Hepatobiliary scintigraphy at 60 minutes after intravenous injection demonstrated that deposit of the tracer still remained in the upper afferent loop jejunum. Therefore, we considered that the recurrent cholangitis, liver abscess, and intrahepatic lithiasis have been caused by biliary stasis due to nonobstructive afferent loop syndrome. Biliary retention due to nonobstructive afferent loop syndrome may cause recurrent cholangitis or liver abscess after hepaticojejunostomy, and double-balloon enteroscopy and hepatobiliary scintigraphy are useful for the diagnosis of nonobstructive afferent loop syndrome.

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Enterolith Causing Afferent Loop Obstruction: A Case Report and Literature Review

Lee

Bui

Knuttinen

et al. 2009

Cardiovasc Intervent Radiol

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Enterolith formation is a rare cause of afferent limb obstruction following Billroth II gastrectomy and Roux-en-Y hepaticojejunostomy surgery. A case of ascending cholangitis caused by an enterolith incarcerated in the afferent loop of a 15-year-old Roux-en-Y hepaticojejunostomy was emergently decompressed under direct ultrasound guidance prior to surgery. This is the thirteenth reported case of an enterolith causing afferent loop obstruction. A discussion of our management approach and a review of the relevant literature are presented.

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Jejunal Loop Obstruction by a Gallstone from Hepaticojejunostomy-Induced Acute Cholangitis: Report of a Case

Cited by 5 publications

References 12 publications

Gallstone ileus 30 years after cholecystectomy and hepaticojejunostomy

Gallstone ileus 30 years after cholecystectomy and hepaticojejunostomy

Recurrent Cholangitis by Biliary Stasis Due to Non-Obstructive Afferent Loop Syndrome After Pylorus-Preserving Pancreatoduodenectomy: Report of a Case

Enterolith Causing Afferent Loop Obstruction: A Case Report and Literature Review

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