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Figure 3.37. Antral narrowing after gastroenterostomy. (A) Single view from an upper GI series showing smooth antral narrowing after gastroenterostomy. (B) View of a different patient with similar findings.
Figure 3.38. "Viscious circle" after gastroenterostomy. Supine view from an upper GI series shows filling of the afferent limb only. On fluoroscopy, barium was seen entering the A limb, then flowing retrograde into the stomach and back into the afferent limb.

"Viscious Circle"

Another complication of gastroenterostomy is the so-called viscious circle, when partial obstruction of the efferent limb causes food or contrast medium to be directed through the anastomosis into the A limb and retrograde through the pylorus back into the stomach. This sequence may be observed fluoroscopically and documented radi-ographically (Fig. 3.38). Revision of the anastomosis is required to correct the condition.

Gastroileostomy

Gastroileostomy is a possible iatrogenic complication of gastroenteros-tomy that is readily diagnosed in upper GI series by identifying direct communication between the stomach and the ileum.

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