A RARE POST-GASTRECTOMY COMPLICATION: EFFERENT LOOP VOLVULUS

Efferent loop syndrome (ELS) is a rare postoperative complication that may occur after Billroth II or Roux-en-Y gastric reconstruction. Although less frequent than afferent loop syndrome, it can lead to severe obstructive symptoms requiring urgent surgical management.We report a case of acute efferent loop syndrome caused by volvulus of the alimentary limb in a patient with a history of partial gastrectomy and Billroth II gastrojejunostomy. The patient presented with acute intestinal obstruction, and contrast-enhanced CT imaging revealed a markedly distended efferent loop with radiological signs suggestive of ischemia. Emergency surgery confirmed a volvulated and necrotic jejunal loop, which was resected before reconstruction with a new Billroth II anastomosis. Postoperative evolution was uneventful.This case highlights the importance of considering ELS in the differential diagnosis of post-gastrectomy patients presenting with obstructive symptoms. Early recognition and timely surgical intervention remain essential to prevent ischemic complications and improve outcomes.