A case of systemic sclerosis sine scleroderma associated with perforation of an afferent loop after subtotal gastrectomy with Billroth 2 anastomosis for its severe gastrointestinal involvement.

A 50-year-old man was admitted to hospital for dysphagia. The upper gastrointestinal series revealed esophageal stricture, pyloric stenosis, and hypomotile small intestine. He was diagnosed with systemic sclerosis sine scleroderma with gastrointestinal involvement. After subtotal gastrectomy with Billroth 2 anastomosis, he had recurrent intestinal pseudo-obstruction and perforation of the afferent loop. Our experience indicates that surgical procedures in bowel scleroderma, in which an afferent loop is reconstructed, could easily cause perforation of the afferent loop.