# Afferent loop obstruction induced by gallstone ileus after Whipple procedure: a case report and literature review

## TL;DR

A rare case of a blocked digestive tract caused by a gallstone after a Whipple surgery is reported, highlighting the importance of surgical details to prevent such complications.

## Contribution

This case report presents a rare instance of gallstone ileus causing afferent loop obstruction after a Whipple procedure.

## Key findings

- Computed tomography and MRCP confirmed gallstone ileus as the cause of afferent loop obstruction.
- Internal herniation, adhesions, and a stuck pancreatic duct catheter were identified as contributing factors.
- Emergency surgery resolved the obstruction and the patient recovered successfully.

## Abstract

Afferent loop obstruction (ALO) induced by gallstone ileus after pancreaticoduodenectomy (PD) is rare. We present a case of ALO after the Whipple procedure in a 62-year-old male with a rare cause of gallstone ileus. He was admitted to the hospital with epigastric pain, fever, and jaundice two years after experiencing intermittent abdominal pain. With the help of computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) gallstone ileus was confirmed and the patient underwent emergency surgery. Intraoperative findings indicated that internal herniation, adhesions and a stuck intra-pancreatic duct catheter caused gallstone formation and eventually led to ALO. The patient underwent prompt surgical intervention and ultimately recovered well. This case report holds a significant potential to contribute to the focus on the details of the Whipple procedure to prevent ALO and gallstone ileus.