Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2015; 21(16): 5110-5114
Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.5110
Management of post-gastrectomy anastomosis site obstruction with a self-expandable metallic stent
Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Kyung Soo Bae, Sang-Ho Jeong, Chang Yoon Ha
Ra Ri Cha, Sang Soo Lee, Hyunjin Kim, Hong Jun Kim, Tae-Hyo Kim, Woon Tae Jung, Ok Jae Lee, Chang Yoon Ha, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea
Kyung Soo Bae, Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea
Sang-Ho Jeong, Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Gyeongnam 660-702, South Korea
Author contributions: Cha RR and Ha CY contributed equally to this work; Ha CY designed the study; Ha CY, Lee SS, Kim H, Kim TH, Kim HJ, Jung WT, Lee OJ, Bae KS and Jeong SH performed data collection and analysis; Cha RR, Ha CY and Jeong SH wrote the paper.
Ethics approval: The study was reviewed and approved by the Gyeongsang National University Hospital Institutional Review Board (GNUH 2014-12-007).
Informed consent: All study participants or their legal guardian provided informed written consent prior to study enrollment.
Conflict-of-interest: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chang Yoon Ha, MD, Department of Internal Medicine, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju-si, Gyeongnam 660-702, South Korea. cyha@gnu.ac.kr
Telephone: +82-55-7508057 Fax: +82-55-7589122
Received: September 30, 2014
Peer-review started: September 30, 2014
First decision: October 29, 2014
Revised: November 13, 2014
Accepted: February 5, 2015
Article in press: February 5, 2015
Published online: April 28, 2015
Abstract

Post-gastrectomy anastomosis site obstruction is a relatively rare complication after a subtotal gastrectomy. We present a case of a 75-year-old man who underwent a truncal vagotomy, omental patch, gastrojejunostomy, and Braun anastomosis for duodenal ulcer perforation and a gastric outlet obstruction. Following the 10th postoperative day, the patient complained of abdominal discomfort and vomiting. We diagnosed post-gastrectomy anastomosis site obstruction by an upper gastrointestinal series and an upper endoscopic examination. We inserted a self-expandable metallic stent (SEMS) at the anastomosis site. The stent was fully expanded after deployment. On the day following the stent insertion, the patient began to eat, and his abdominal discomfort was resolved. This paper describes the successful management of post-gastrectomy anastomosis site obstruction with temporary placement of a SEMS.

Keywords: Efferent loop syndrome, Postgastrectomy syndrome, Self-expandable metallic stent

Core tip: Post-gastrectomy anastomosis site obstruction is a relatively rare complication in patients following gastric surgery; however, it could cause serious discomfort and carries a risk of deterioration of the condition of the patient if a re-operation is required. We report successful management for post-gastrectomy anastomosis site obstruction with temporary placement of a self-expandable metallic stent.