A Bezoar That Caused Afferent Loop Syndrome and Pancreatitis

Korean J Gastrointest Endosc > Volume 39(5); 2009 > Article

Korean Journal of Gastrointestinal Endoscopy 2009;39(5): 291-295.

수입각 증후군과 췌장염을 유발한 위석

최혁순ㆍ김창덕ㆍ강현석ㆍ윤석배ㆍ진윤태ㆍ전훈재ㆍ엄순호ㆍ류호상

고려대학교 의과대학 내과학교실, 소화기 연구소

A Bezoar That Caused Afferent Loop Syndrome and Pancreatitis

Hyuk Soon Choi, M.D., Chang Duck Kim, M.D., Hyun Seok Kang, M.D., Seok Bae Yoon, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Soon Ho Um, M.D. and Ho Sang Ryu, M.D.

Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea

Abstract

Bezoars are conglomerates of nondigestible matter in the gastrointestinal tract that may or may not be accompanied by gastrointestinal manifestations. Bezoars develop in patients with previous gastric surgery or in those patients with delayed gastric emptying that is due to gastroparesis caused by hypothyroidism or diabetes mellitus. Small bowel obstruction due to a gastric bezoar is rare, but it can lead to severe complications such as intestinal perforation, compression necrosis etc. A female patient came to our department complaining of upper abdominal pain and she was diagnosed as having a bezoar that was causing afferent loop syndrome and pancreatitis. We attempted to manage the patient by inserting a nasogastric tube, performing gastrofibroscopy and implementing percutaneous transhepatic biliary drainage, but the patient's condition worsened and deteriorated into a septic condition. An operation was planned, but the patient showed improvement owing to the migration of the bezoar. Herein, we report on a case of afferent loop syndrome due to bezoar and this was complicated by acute pancreatitis. (Korean J Gastrointest Endosc 2009;39:291-295)

Key Words: Bezoar, Afferent loop syndrome, Pancreatitis