MR cholangiopancreatography (MRCP) in the diagnosis of afferent loop syndrome presenting with obstructive jaundice

Abstract

Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive imaging technique that capitalizes on the ingeunity of magnetic resonance imaging (MRI) to visualize static fluid-filled structures without use of contrast agents. A case of afferent loop syndrome presenting with obstructive jaundice is presented, diagnosed using this imaging modality. The patient, who had undergone Billroth II partial gastrectomy for benign ulcer 15 years ago, was admitted for jaundice, nause and vomiting.

MRCP showed dilatation of biliary and pancreatic ducts as well as a dilated afferent loop. No tumorous lesion was detected as the cause of the afferent loop obstruction. Intraoperatively, adhesive band near the anostomosis was seen. After adhesiolysis jaundice disappeared completely. This is the second case in the literature, describing the MRCP findings of obstructive jaundice secondary to a chronic afferent loop obstruction.