Endoscopic treatment of efferent loop syndrome with insertion of double pigtail stent

Abstract

Efferent loop syndrome is a very rare postgastrectomy syndrome that can occur following Billroth-II or Roux-en-Y reconstruction. The most common loop syndrome after gastric surgery is afferent loop syndrome; however, efferent loop syndrome has been reported in rare cases. Here, we report a case of efferent loop obstruction that occurred after postoperative adhesiolysis of a small-bowel obstruction. The patient had undergone a partial gastrectomy with Billroth II anastomosis and gastric ulcer perforation 30 years prior. The efferent loop obstruction was successfully resolved by the insertion of a double pigtail stent. To the best of our knowledge, this is the first case in the literature describing the treatment of efferent loop obstruction.

Keywords: Efferent loop syndrome; Double pigtail stent; Postgastrectomy syndrome

Core tip: We report the successful treatment of a patient with efferent loop syndrome by implantation of a double pigtail stent. Efferent loop syndrome is a very rare postgastrectomy syndrome that can occur following Billroth-II or Roux-en-Y reconstruction. Surgical treatment is usually required. However, in this case, efferent loop obstruction was successfully resolved by the insertion of a double pigtail stent. A double pigtail stent should be considered a treatment option for relieving efferent loop obstruction if immediate surgical treatment is not required.