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Afferent loop syndrome (ALS) is an infrequent complication originally described with Billroth II gastrojejunostomy. It is caused by mechanical obstruction owing to internal herniation, volvulus or narrowing of the anastomosis. Similarly, an obstruction of the biliopancreatic limb of Rouxen-Y reconstruction can rarely cause ALS. Early diagnosis and surgical intervention are crucial to decrease morbidity and mortality in acute ALS.

Afferent loop syndrome caused by stenosis of jejunojejunal anastomosis of Roux-en-Y reconstruction