PMC4188946_01
Tight angulation of the efferent limb of a gastrojejunal anastomosis. A catheter is successfully passed across the angulation
AnnGastroenterol-27-413-g001.jpg
PMC4188946_01_AnnGastroenterol-27-413-g001.jpg
F1
Upper endoscopy demonstrated a tight angulation at the efferent limb anastomosis (Fig. 1).
Positron emission tomography computed tomography scan demonstrating malignant recurrence surrounding an efferent limb stent
AnnGastroenterol-27-413-g002.jpg
PMC4188946_01_AnnGastroenterol-27-413-g002.jpg
F2
Positron emission tomography CT scan demonstrated malignant recurrence surrounding the stent (Fig. 2).
Fluoroscopy image demonstrating placement of an afferent limb stent alongside an efferent limb stent in a patient with both afferent and efferent limb obstruction
AnnGastroenterol-27-413-g003.jpg
PMC4188946_01_AnnGastroenterol-27-413-g003.jpg
F3
Esophagogastroduodenoscopy (EGD) revealed a strictured afferent limb and an uncovered metal stent (22 mm x 90 mm, Evolution Duodenal Stent, Cook Medical, Bloomington, IN) was placed (Fig. 3).
A metal stent in the afferent limb and three metal stents in the efferent limb in a patient with afferent loop syndrome and recurrent malignant obstruction of the efferent limb
AnnGastroenterol-27-413-g004.jpg
PMC4188946_01_AnnGastroenterol-27-413-g004.jpg
F4
Duodenal Stent, Cook Medical, Bloomington, IN) was placed through the existing stents (Fig. 4). Despite chemotherapy, the patient developed omental metastases and an enlarging porta hepatis mass.
PMC4188946_02
PMC4188946_03
PMC4188946_04