| Papilla in an afferent loop after BII surgery |
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The major duodenal papilla is
approached
from aboral in patients with Billroth II
gastrojejunostomy via the afferent loop.
The location is usually 3-5 cm prior to
the dead end of the loop.
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The duodenoscope is positioned
in a "U" shape
manner. The picture shows a tumor infiltration
by an advanced cancer of the pancreatic head.
Surprisingly there was no congestion of the
pancreatic duct, which might be a hint towards
a carcinoma of acinar cell origin.
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In
this picture the plica horizontalis is clearly seen
upside down. See also
Normal appearance.
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