A 60-year-old man who underwent Billroth II gastrectomy 5 years ago presents with postprandium colicky abdominal pain followed by forceful bilious vomiting that relieves the pain. Abdominal examination is unremarkable. What is the most likely diagnosis?
- A Afferent loop syndrome ✓
- B Early dumping syndrome
- C Alkaline reflux gastritis
- D Efferent loop obstruction
Correct answer: A. Afferent loop syndrome
Explanation
Afferent loop syndrome classically presents with postprandial colicky pain followed by forceful bilious vomiting that relieves symptoms, as food and secretions accumulate in the obstructed afferent loop and then reflux back. It is specific to Billroth II reconstruction. Early dumping syndrome has non-bilious vomiting with vasomotil symptoms. Alkaline reflux causes persistent burning pain without relief from vomiting.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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