‘O’ Configuration of Biliary-Enteric Drainage: a Preventable Surgical Error

Abstract

Surgical errors in Roux limb reconstruction are not reported widely. A young male who underwent hepaticojejunostomy after biliary injury developed acute obstruction of the proximal jejunum. Barium study revealed the O configuration of alimentary limb—‘O’ sign. At laparotomy, he was found to have the alimentary limb joining on to itself and without any connection with the biliary limb. The O loop complex was resected, and Roux-en-Y construction was refashioned. He made an uneventful recovery and is well at one year follow-up. We have reviewed the literature and propose a classification system for such type of errors. Every effort should be made to prevent this complication.